I was sitting on a bench in the pharmacy, across the street from the retirement community where I worked-still wearing my R.N. badge, but technically off duty. It was one hour and 15 minutes since I'd given report and handed over the keys to the evening supervisor.  My husband and I had symphony tickets. Once I made it home, there'd be just enough time for me to change out of my uniform. I'd already given up on the leisurely dinner. 

All afternoon I'd been working my way down the list of residents for whom I provided help with medication management.  It was an aspect of my job that was increasingly fraught with complications. Whereas it used to be that all the residents on my list had their prescriptions filled locally (by pharmacists I knew by name and by familiar phone number), now it seemed certain residents wanted to switch to mail-order systems. The challenge was that of helping elderly residents to get their medications at the best going rate - and to get those medications in hand, on time. Sometimes I felt more like a consumer advocate than a nurse.    

But the nursing aspect of my job (the caring part) was still connected to the on time part. And so it came to pass that late in the day on which I had symphony tickets, a certain resident - Mrs. A on the third floor - called me in a panic. It seemed that (for reasons she didn't quite understand) she had exactly one Lanoxin left in the bottle, and yet the mail-order people had just informed her that she couldn't have another order sent for another week.  
And so it was that I was sitting on the bench in the pharmacy across the street, waiting for Mrs. A's emergency prescription to be filled.

But in the end, this isn't a story about a mail-order glitch or even about my personal frustrations. In the end, it's a little drama, one that I witnessed as I sat glaring at the clock in the pharmacy.

There was an elderly woman leaning on the counter.  She was arguing with the young man waiting on her. "It can't be that much," she was saying. Her color was ashen. She was short of breath.

"Here," the young man said, showing her the paper attached to her prescription bag. I could tell he was a nice kid, but it was clear he had his script. "They called your insurance company. This prescription isn't covered."

The woman didn't even look at the paper. "It has to be covered," she said.  

"I'm sorry, ma'am.  They say it's not."

"Well you can just keep it then."  She said this with so much venom that anyone in earshot would just naturally sympathize with the poor kid trying to do his job. "You can just take it yourself," she said. "I sure don't have that kind of money."  And she turned on her heel and walked away-short of breath, her color ashen.  

Sitting on the counter was the bag holding the prescription medications that a doctor had ordered, and a pharmacist had duly filled-the prescription she'd didn't have that kind of money to pay for. And so here is the dark ending to the story about the day I ended up sitting in the pharmacy after work, and was almost late for the symphony: 

This elderly woman gets a prescription.
This elderly woman gets none.
Another story about a healthcare system that seems to have come undone. 

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