PHARMACY TELLTALES 101: WHAT WE SEE BEHIND THE COUNTER
By: MIYINGO Ivan, MPhil, B.Pharm, MPS
📖 CHAPTER ONE: WHAT WE SEE BEHIND THE COUNTER
The first thing you learn behind the counter is this:
People don’t tell the truth.
And most of those stories are unfinished.
The pharmacy opens before the city fully wakes.
There is a quiet moment—brief, fragile—before the doors swing and the day begins. Shelves stand in perfect order. Labels face forward. Blister packs shine under fluorescent light. Everything looks controlled, predictable, scientific.
But that illusion never lasts.
Because outside, life is not organized into dosages.
Outside, people are already negotiating with pain.
The first patient that morning does not look sick.
He walks in steadily. No limp. No visible discomfort. He greets casually, like someone buying airtime or sugar.
“I need that medicine,” he says.
He does not name it.
He never does.
Instead, he describes it the way people describe things they are familiar with but do not fully understand.
“The one… for the stomach. The strong one.”
There are many “strong ones.”
I ask questions, carefully, the way you learn to do over time.
“How long have you had the pain?”
He hesitates.
“A few days.”
It is never a few days.
You learn to hear what is not said.
A few days can mean:
- Three weeks
- Three months
- Or something that has been quietly growing for years
Pain teaches people patience in the worst way. It convinces them that endurance is the same as healing.
He avoids eye contact when I ask about other symptoms.
“Any vomiting?”
“No.”
“Fever?”
“No.”
“Have you taken anything already?”
A pause.
“Just Panadol.”
It is almost always more than Panadol.
Behind the counter, you begin to understand that medicine is not just about chemistry.
It is about negotiation.
I give him something mild first.
Not because I believe it will cure him.
But because sometimes treatment is not only about the disease—it is about the distance a person is willing to travel toward the truth.
And when they disappear, they don’t stop being sick.
They just become invisible.
He leaves with the medicine in a small black polythene bag.
He looks satisfied.
Relieved, even.
As if something has been solved.
But nothing has been solved.
By midday, the pharmacy is full.
Different faces. Same patterns.
A mother walks in with a child on her hip. The child is quiet—too quiet. Not crying, not restless. Just watching.
“You have something for flu?” she asks.
“How long?”
“Since yesterday.”
Again, yesterday.
Yesterday is one of the most common lies in a pharmacy.
I look at the child.
Dry lips. Slightly sunken eyes. Breathing just a little faster than normal.
The body always tells a clearer story than the words.
“Has the child been eating?”
“Not really.”
“Drinking?”
“A little.”
“Any diarrhea?”
A pause.
“Yes.”
“Vomiting?”
Another pause.
“Yes.”
Now the story begins to unfold.
Not because she suddenly wants to tell the truth—
But because truth, like illness, has a way of surfacing when pressure is applied in the right places.
You realize something after enough days behind the counter:
People don’t lie to you.
They lie to what your questions represent.
Doctors. Hospitals. Costs. Fear. Diagnosis. Reality.
You are not just a pharmacist.
You are the doorway to consequences.
I explain what I think is happening.
Dehydration.
Possible infection.
The kind of situation that cannot be managed casually.
She listens, but her eyes drift—not in confusion, but in calculation.
“How much?” she asks.
That question sits at the center of everything.
Because in that moment, medicine collides with economics.
And economics often wins.
I tell her the options.
Oral rehydration. Medication. Possibly a referral.
She nods slowly.
Then chooses the smallest possible version of treatment.
Not because she doesn’t care.
But because caring is limited by what she can afford to act on.
They leave.
And you are left with a quiet discomfort that never fully goes away.
Because knowledge, in this setting, is not always power.
Sometimes it is just awareness—
Of how little control you actually have.
By evening, you are tired.
Not physically.
But mentally.
Because all day, you have been holding fragments of other people’s realities.
Small pieces.
Incomplete pictures.
Half-truths.
And then you begin to see the pattern.
Illness is not just biological.
It is:
- Financial
- Psychological
- Cultural
- Emotional
Sometimes the disease is the smallest part of the problem.
Behind the counter, you stop asking:
“What is wrong with this patient?”
And you start asking:
“What is this person dealing with that has nothing to do with medicine?”
Because the truth is—
Most people do not come to the pharmacy when something begins.
They come when something has already continued for too long.
And in that space—between beginning and arrival—
That is where the real story lives.
This is what we see behind the counter.
Not just symptoms.
Not just prescriptions.
But people, standing at the intersection of pain and decision—
Trying, in their own way, to survive both.
And this is only the first story.
ABOUT THE AUTHOR:
TellTales from a freelance pharmacist and Atiah Miyingo's daddy documenting the unseen human condition through illness, survival, music, and truth.
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