Scruffy Nerf Herder

As odd as it sounds, one of my favorite responsibilities of my relatively new profession is pretty mindless. I can fall into the rhythm of pill counting and lose myself to the patterns of circles and ovals for as long as the scripts to fill hold out (or other obligations fail to intrude).

I’m somewhat surprised at this. Perhaps the most denigrating thing you can say about a pharmacy technician (or pharmacist, for that matter) is that they are nothing more than pill-counters. The skill in counting pills is perceived to be minimal, and the relative worth of someone who can do it well is likewise minimalized. Perhaps there’s good reason for this; it probably is a skill that most people could do adequately. But to do it adequately (which is all the job requires of me at the moment) is not the same as excelling at it.

I’ve been a pattern finder since I was too young to understand what I was doing. I like to find how things repeat, how to predict what comes next, how things fit together with what came before and what comes after. And there are predictable patterns in how small and usually rounded objects tend to group when spilled out onto a flat surface. Being able to recognize these patterns and herd them away from the group increases both speed and accuracy. It isn’t anything they teach you about pharmacy courses. (Hell, they don’t teach you about counting pills at all in the courses, they just introduce you to how to use a pill tray, which is nothing I want to get into here but is fairly simple.) It’s just something I noticed on the job, and something I’ve tried to use and notice more about.

North American pharmacies count pills in groups of five. Counting by five is easy, most scripts are in multiples of fives, and groupings of five are easy to manipulate. I’ve found that groupings of five will assume only a few limited patterns, which means that I don’t have to actually count five pills each time I sweep pills into the trough of the tray with my spatula; I only have to recognize the patterns.

For round pills, the patterns are these:

ooooo
8ooo
oo8o
8o8
88o

I can probably count out 180 circular pills in less than fifteen seconds by just recognizing the patterns and cutting them out of the herd.

Oblong tablets are a little trickier, since the patterns can get stretched out and distorted by the angle of the tablets in relation to the other tablets in the pill herd. Capsules can be even more difficult (at least at times) because they tend to pick up static and stick together, making it challenging to sort the pattern out of the herd. Gel caps are a bitch because they like to roll, and your target pattern is constantly on the move. A few pills like alprazolam are a pain in the butt because they are long, rectangular and act like a bunch of sticks in a game of pick-up-sticks.

I don’t spend my days at the back counter with my herds of pill-sheep and my collie dog spatula cutting groups of five from the flock and corralling them in the pill-trough. I’m lucky if I get to do it for more than ten minutes at a time. But when I get to do it, I enjoy it. Far from demeaning, it’s as challenging as you choose to make it, and it’s great stress relief.