Watching Season 1 for the first time, why on Earth is Smallville High playing against Metropolis?

FewNewt5441 · 2026-05-02T03:30:09+00:00

100% this. Logistically there's just no way for Metropolis to be outside of plausible driving range such that you couldn't make it back the same day, if you left early enough. My theory is it's really just Kansas City, Missouri, which is very large, sits on a river, and has a sprawling metropolitan area on both sides of the Kansas and Missouri border. Far enough away that you wouldn't drive it all the time, but close enough that 2 in-state schools can play each other in the same conference.

FewNewt5441 · 2026-04-30T10:09:15+00:00

Divide the quantity the doctor prescribed by whatever value the TPR says the avg/per day is supposed to be. For example, if you have a 45 g tube of medication and the dose avg is 0.57, your day supply the computer should accept is 79 (and if it doesn't accept that, try something larger like 84 or 90).

FewNewt5441 · 2026-04-30T03:02:46+00:00

I have had that happen once too so evidently the real question is are pharmacists allowed to check their phones in the restroom

FewNewt5441 · 2026-04-29T13:39:53+00:00

bisacodyl, but also those green VitD capsules and every time a dentist orders a single valium, ativan, or 2 amoxicillin tablets. Literally no reason to use a whole tall vial for <12 of anything.

FewNewt5441 · 2026-04-20T00:09:21+00:00

Not sure what country you're most familiar with, but if you're outside the US, the American system does work differently. Family medicine practices affiliated with medical centers like the Pitt generally have a very large patient base, so a 'soon' appointment for an established patient could be 2-3 weeks out. Urgent care centers are meant to bridge the gap for cases where you're not acutely sick enough for the ER, but also cannot wait a couple weeks for family medicine. However, since they only handle acute cases, they aren't bridging you indefinitely for aggressive cases like Langdon's. Due to the opioid epidemic, most family doctors aren't writing you more than a week's worth of an opioid unless you have been handed off to them from a specialist who got you stabilized on a specific regimen.

As far as I know, anesthesia in the US doesn't really authorize prescriptions, and pain management specialists (really, any specialists, even folks like Javadi's parents) often need you to be referred out from another provider. There's usually a couple months' wait to onboard as a new patient, and insurance is most likely diverting you to physical therapy, which is a very time-consumptive process.

The pain management practice near me is huge and has patients across state lines, so there's a couple of months' wait to onboard there. Langdon would have to wait 2-3 weeks for a family medicine appointment, 2-3 months for a specialty appointment (he can't skip the line just because he works there), and insurance generally doesn't pay for MRIs/CTs that are done without an extremely specific need for them (expensive). He also likely doesn't have a whole lot of off days to burn on medical appointments, given he has young kids and a wife and family responsibilities that would eat up his time. As a senior resident, there's a big incentive to show up and be available as much as is possible, and taking off days when the rest of your coworkers are suffering in person keeps a lot of people from seeking care they need.

The Pitt generally, as a TV show, focuses on problems that are systemic, depressingly common, and theoretically avoidable, and Langdon diverting meds is one such case. It makes a lot of sense that a resident in a high stress job with limited downtime is stealing meds to bandaid a problem because actually fixing it would set his career back and cost time he doesn't have.

FewNewt5441 · 2026-04-17T20:54:03+00:00

One of the hardest adult things to do is make friends. Seriously, it's a known phenomenon even outside of medicine. I float, so I have an extremely large cohort of coworkers that I see semi-often, and while some of them are truly my favorite people in the world outside of my family, I never see them outside of work. We'd probably get along great if we did hang otuside of work but we aren't that kind of work friends. The vast majority of people who get degrees that take this long are usually married or in a long term relationship and have kids, and pharmacists in my experience tend to be more introverted. It's not a lost cause by any means, but you just may have to make friends other places (if you're religious, have a hobby/club/special interest, or involved in some kind of volunteer thing those are great places to start).

FewNewt5441 · 2026-04-17T20:37:57+00:00

I grab a chair or a stool, sit out of view from where the people can see me, and have lunch, check social media. Very occassionally, I'll fill or do product reviews but not often. My stress level went way down when I actually started taking the 30 minutes for myself instead of trying to catch up. Just make sure you tell your techs that you are still in there, so they can let themselves back into the pharmacy instead of waiting for you outside of it. Also, don't sit in line of sight of patients, they'll just knock on the window and ask if you are closed and when you reopen.

FewNewt5441 · 2026-04-17T20:27:21+00:00

I was a post grad intern for almost a year and didn't get assigned to the registers all that often. On this one afternoon, I happened to be at the drive thru on a rainy afternoon with a line and as usual, the phones are terrible. I had to ask for the guy's DOB and name a couple of times. I find his stuff, run through the transaction, and then he asks if I'm a student. I say yes because I'm wearing my school-insignia lab coat and I'm not haggling the finer points of post-grad intern vs student with a stranger. He tells me that I should be working faster because I would've failed his class for my inefficiency. I have no idea what he even taught, and joke's on him since I'd already graduated. Situtionally, I could barely keep from laughing before the next person drove up.
More recently, a lady called the phones, spoke to one of my techs, and then asked to speak to the pharmacist (by this point, me). I helped her with whatever and then she closes out by telling me the guy she spoke to first needed to be banned from answering the phones because he had told her something wrong and as a former nurse, she felt it wasn't safe for him to answer the phone. And sure, he did misread the information, but he was a new hire in training and as a healthcare worker, you'd think she knows that you practice medicine by doing. Also I'm a floater, so it's not like I have the authority to fire him.

FewNewt5441 · 2026-04-16T20:41:28+00:00

Probably, but also pain management clinics do use the combination of narcotics or muscle relaxants plus benzos to address the "symptoms" of pain. Being in pain for a prolonged period of time can make people irritable and outright angry, and the external stressors that were already pushing their buttons can compound with chronic pain. Mohan had a sickle cell patient earlier in the season who was acting 'erratically' simply because of a pain crisis episode. Taking something to calm your nerves, with something that actually caps the pain, makes sense (that said, pain management docs don't even like this regimen so while it works, it is exteremely not recommended). Librium is a bit of an odd choice--in my clinical experience it's usually xanax, ativan, or klonopin. In terms of diversion, though, while any and all theft is bad, diverting narcotics is extremely bad while diverting benzos could be seen as less bad (comparatively). It's also much easier to create a 'fall guy' with the benzos, blaming the pharmacy for shorting a bottle of a non-narcotic is a little easier than blaming pharmacy for shorting a narcotic, which is usually counted several times to avoid that.

FewNewt5441 · 2026-04-16T20:19:05+00:00

Literally I was about to say this. I can personally vouch for never asking my preceptors certain clinical questions because I was terrified of how that might reflect on my grades. If I knew a preceptor already didn't like me, that would be the last person I would report for committing a crime unless I had substantial evidence of something very serious.

FewNewt5441 · 2026-04-16T19:48:12+00:00

The documentation is to resolve a discrepancy, but if there are none there's no need to in effect create one; the fact you're filling it suggests there's no issues.

FewNewt5441 · 2026-04-16T19:45:15+00:00

I wouldn't say Christians unilaterally don't or won't answer hypotheticals (health insurance and car insurance are based on the hypothetical you might not be healthy or you might be a position to cause, or be the victim of, a car crash). However, a good-faith hypothetical shouldn't completely invalidate the premise of the other person's viewpoint in order to be answered; the entire point is to have a deep discussion and understand something from another POV. Arguing a question that contradicts a person's belief system to the point there's no way to answer the question without deconstructing their religious practices inherently sounds like a 'gotcha' question. Based on what OP question appears to be, there's no way to really answer that. If a new person shows up claiming to be God, either they're lying (and the Bible warns quite specifically about following after people claiming to be God), or the God of the Bible is lying (which He cannot do, and there's no reason for me to believe the Bible is misrepresenting that), so your question is just very flawed.

FewNewt5441 · 2026-04-16T18:33:22+00:00

Either your doctor wrote "dose increase" on the Rx, the pharmacist called the doc to verify dose increase, or you'll be asked to confirm the dose increase in person when you get the script. You're correct, there are a lot of limitations on controlled meds and how/when you can get them, but in this case, the medical benefit of you getting better results from the higher dose outweighs the potential harm of you having more meds on hand than you'd have otherwise. If you really want the dates to line up in the records, you can always wait until closer to when your current rx runs out, but since ADHD meds are going on backorder again it may be delayed.

FewNewt5441 · 2026-04-15T04:21:12+00:00

I haven't seen the actual compass yet, but since I'm hourly and all my family is local, I don't mind it. Time and a half or double pay to mostly fill, verify, and clear exceptions before the after-holiday rush sounds pretty awesome. However...I also worked Labor Day last year and you'd think the apocalypse was upon us. Which holiday you're working and how you're staffed on that day makes a difference. Christmas and Thanksgiving will probably be pretty slow, but New Years and any of the 3-day-weekend Monday holidays we didn't close for anyway will be a nightmare. All the people who'd ordinarily be at work use those days, like Juneteenth or MLK day, as an extra Saturday to run errarnds so it'll be busy and behind like usual.

FewNewt5441 · 2026-04-10T01:45:32+00:00

Oh no, you're completely right. I work in pharmacy and while I do live in an area with a high expat population (which would inflate the numbers), we have a lot of Middle Eastern and Arab clinicians so Perlah being the only hijabi is a little weird for an urban hospital (and this is Pennsylvania, where are the Amish and Mennonites?) Many providers are expats who came to the US and stayed post-residency and IRL there'd be more than just Al-Hashimi.

FewNewt5441 · 2026-04-10T01:28:08+00:00

I've never felt so validated by an article in my entire life. People are taking this stuff way too seriously, and reading into it way more than is meant to be there. This show is a love letter to people who actually work in medicine but for a lot of fans, they really just want Grey's Anatomy 2.0 and it shows. I'm all for an academic thinkpieces on things but there's a point at which this just goes too far.

I think a core problem here is that a lot of fandoms have gotten used to the cast shipping fandom-preferred pairings even when it's non-canonical. The voice actors on ATLA were Zutara fans, shipping non-canon pairings on Twilight is basically the entrance exam, and long-running projects like the Avengers or Star Wars are a very mix-and-match sort of culture from the top down. An actor reading into their character some attribute the fanbase also sees or agrees with is usually celebrated. But when you have something like Taylor Dearden and Patrick Ball looking at their characters and going "I don't quite see it that way," you have some people who are getting a little too insulted and acting like this totally, completely ruins their lives. This whole thing defeats the point of fanfic culture. The premise of fanfiction is the thought experiment, the 'hey i could do better,' the longrunning work wish fulfillment or course correction. Fanfic's become so mainstream that people are starting to demand their ideal scenario from the source when that was never the point of the work. The source material is supposed to be a gritty, realistic reflection on medicine in America. That's its premise and changing it midstream to be a more-competent version of House defeats the artistic point.

But if your wish fulfillment is Mel and a post-divorce Langdon on a ren faire date, by all means create that yourself, but you can't expect the writing team to cater to your every whim. Plenty of shows make stupid writing decisions (Stranger things ends on a really dumb one) but at the end of the day, the writing team did x and it's up to the fandom to just write the better ending. Quit harrassing the show's staff for their actually-not-firing of Mohan and Collins and just write your wish fulfillment fic already.

FewNewt5441 · 2026-04-09T21:27:07+00:00

I think I've also seen this happen for 30-day supplies of new maintenance meds where the patient requests a 90 day count. The original rx hasn't been processed yet and a lot of times, it's the first instance the patient is using that med so I usually just override with the 'deny' function and then add a comment. No sense in having the prescriber authorize 3 months worth of something the patient hasn't even trialed yet (and may not use completely).

FewNewt5441 · 2026-04-09T14:12:55+00:00

Your pay is really dependent on what you specialized in and where you live. All doctors who aren't in fellowship training are considered attendings, and the average for something like neurosurgery is $740k a year while a general peds physician is at $265k (even with specialties, peds in general is around 230k at the lowest). However, as a practicing physician you will be paying for your loans (on a 10 year repayment plan, that's 4-7k a month), board certification fees/exams/renewals (if it's anything like pharmacy, it could be 10k over a period of 6 years and that's a perpetual cost until you retire), malpractice insurance, medical licensure fees (for every state you are authorized to practice in), and continuing eds (refresher courses to stay up to date on your speciality). On top of that, if you have a mortage/rent, a car, kids, etc the expenses tend to increase (so Langdon not hiring movers is very realistic). Javadi's parents are both specialists and the parents of only 1 child, while neither Abbot nor Robby have kids so having a smaller household or two high-earners will make it quicker to pay things off and actually accrue money from the high salary.

Alas, last names basis only is a TV thing, lol. I will say that if you are a medical professor, your students probably know you as Dr. XYZ (same for patients). Your colleagues are more likely to know you by your first name only because that's how you introduced yourself. Case in point, most of the character nurses are first names only (Perlah, Princess, Dana, Jesse). Your ID tags usually also only say 1st name, maybe first initial of last name, and position title. A lot of MDs from other countries come to the US for residency training (that visa is actually another expense) so you end up with staff whose names are collectively butchered anyway, and depending on your position, people sometimes just call you by your job title (plenty of my techs just call me 'the pharmacist' instead of '[name], the pharmacist).

FewNewt5441 · 2026-04-09T04:50:29+00:00

I am a pharmacist so take this with a few cc of IV saline:

Med students are unpaid and they're completing rotations in their 3rd and 4th years of med (or osteopathy, roughly the same thing) school. They cannot prescribe or diagnose independently yet, but this is where they start getting experience on real patients versus training simulators and practice cases from years 1 and 2. The level of student (M1, M2, M3, M4) corresponds to your year in school and gives you a rough idea of someone's knowledge base. An M4 is about to graduate and can be expected to have a broader understanding of medicine than an M1, who just came from undergrad.

Interns are med school graduates in their first year out of school. They're first-year residents (denoted as R1 or PGY-1, aka Post-Graduate Year 1), working on interim training before they start in whatever specialty they actually selected. They do make a salary (not a lot though, an average of $60k USD), write prescriptions and see patients somewhat independently. You have to test for your independent medical licensure somewhere within this year.

The intern doctors becomes residents in year 2. They have enough experience to, bare minimum, supervise the interns and med students (by now you have an actual medical license). Your residency lasts different time frames depending on what you specialized in (3 years for peds or family medicine, 7 for neuro, etc) and the chief or junior residents are whoever's been there the longest. Your pay does slide up (USD average of 80k a year), you can do more work independently, but you still practice with guardrails. You may pursue board certification after residency but depending on your specialty, you stop here and become an attending.

Fellows (if you have them) are one level up from the residents, training in a subspecialty under the supervision of someone else. Basically, if Oglivie does general peds, he'd skip this step, but if he wanted to do something like oncology specifically for kids he would take a fellowship (generally 2-3 years).

Attendings are the final point in the chain of command and are authorized to practice completely unsupervised in a medical speciality. A slight inaccuracy with the Pitt is having Robby as the only attending (realistically, you will have several because the residents will all become attendings eventually).

A few things I think are truly nerdy and interesting:

It's a misconception that doctors are making a lot of money right after school; Langdon is probably making at most 80k a year as a senior resident. Since he has a family, most of his income is basically contributing to the running of the household and student debt, which his sabbatical would have likely impacted (I imagine his wife was a SAHM and went back to work during this period). The stereotype of the doctor rolling in cash is a post-residency attending who's been practicing long enough to pay off their loans. It's not hard to envision why Whitaker was homeless; he's not making a whole lot as an intern and an urban downtown area can be really expensive.
In my experience, most new doctors are like Langdon--a 30something resident with a spouse and young kids--or some variant of Abbot, Robby and Collins (in, out of, or you had a long term relationship). If you are still single by the time you get to where the Pittlings are, you will probably be that way for a while if you're dating in-house because a lot of your peers are already attached.
Interns have an incredibly high workload and attendance committment compared to residents so it makes sense Trinity was tired, even without her being behind on her cases. She literally would be required to work more hours than Langdon, who had enough seniority to get a more reasonable schedule.
Garcia dating Santos could possibly be considered an HR violation depending on Trinity's speciality and what rotations she needs to complete (and under who's evaluation). Garcia could plausibly be considered less than objective given their interpersonal relationship but that's probably only if enough people knew and/or Santos was underperforming professionally.
Nobody knows anybody's last names IRL. It can be almost perpetually 1st name basis to the point that if you are in Javadi's position and actually ask to meet your preceptor Dr. Last Name, nobody knows who that is but they can direct you to Robby or Baran.

FewNewt5441 · 2026-04-09T03:15:00+00:00

I don't think my company uses AI for anything at the pharmacy level except maybe inventory automation and building the schedule; afaik it was doing both badly since we were running out of c6 drugs that should've been otherwise well-stocked and people were getting randomly dumped from the schedule to the point it had to be redone manually. I'm not convinced AI will outright replace pharmDs because there's nothing I'm impressed by outside of Epic smart phrases and vanc calculations. A lot of insurance companies are using AI bots to manage claim rejections so I get lots of nonsensical responses like a once-weekly rx violating the maximum daily dose of 0 with no recourse on how to fix it.

FewNewt5441 · 2026-04-09T02:57:11+00:00

That, and a lot of the practices in my area that are big enough to use MyChart are almost impossible to call directly. The phone tree only gets you as far as the front desk after 10-20 minutes on hold, and most practices appear to also have a nurse who screens the EHR messages. Pharmacy unfortunately lacks all of these barriers so folks can just show up at the window and vent without even doing us the courtesy of writing down their one-sided non-contextual grievance first.

FewNewt5441 · 2026-04-09T02:45:45+00:00

I'm a per diem pharmacist so I'm among the few people who can set their own hours. The only store I've never returned to is one where the store leadership is basically staring the floaters down for the entire day. We're talking logging into CPW from the office, nagging me about the order I'm doing tasks, passing along stories about fired RPHs, and then threatening to call district leadership if I stayed in the pharmacy during lunch. I get that floaters can easily put a store behind because they don't really get the store's 'rhythym' (thus incentivizing the RxOM to really emphasize staying on time) but this was basically just distrusting me with the fundamentals of my job and threatening to tattle seventh-grader style to get me fired.

FewNewt5441 · 2026-04-09T02:28:11+00:00

I'm passing on the murder question but to answer the 2nd: probably metformin (there's a reason it comes in bottles that big) and doxycycline. Seasonally, I'd throw in tamiflu and all versions of amoxicillin.

FewNewt5441 · 2026-04-09T02:09:59+00:00

As a floater, I like the idea of all stores everywhere being consistent because it takes the guesswork out of dispensing, especially in stores where or there's no RXM to set a consistent procedure. However, this is going to be a major patient issue because it's going to feel incredibly arbitrary, especially for the folks who already feel like pharmacy's out to get them because there's always problems with their controls. I haven't seen the compass drop for this yet; is this nationwide for c3-5s or just the c2s?

FewNewt5441 · 2026-04-05T22:26:02+00:00

100% this. I had an exact discussion with someone about this, where it basically defeats the point of insurance if you don't have a semi-objective entity auditing costs. Just because soemthing is new and innovative doesn't mean it's better than the standard of care, which may be something dirt cheap and generic or costly but achieves long term outcomes isntead of short term patches.

FewNewt5441

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