The Truth
.....The whole truth
..... ..... And nothing but the truth.
On the TV show Perry Mason from years ago there would always be a courtroom scene and the defendant would always be asked to tell the truth, the whole truth, and nothing but the truth. Even today that holds up in American courts (or so I've been told). But why the three statements?
Well. You can tell the truth but by leaving something out you are being misleading.
In that light you need to tell not just the truth, but ALL of the truth. However, you could keep on talking and then be misleading.
Nothing but the truth. No twisting the words after you have said everything you need to be honest.
Now as a Christian I absolutely believe in honestly.
Thou shall not bear false witness
Exodus 20:16 (KJV):
Is one of the 10 Commandments right up there with things like not murdering people and not stealing their things.
“All you need to say is simply ‘Yes’ or ‘No’; anything beyond this comes from the evil one.”
Matthew 5:37 (NIV)
Simply put: Speak plainly and mean what you say
But there is more to it than just being honest
Image Source: Dall-e
Speaking the truth IS important to me. However, there is also context and restraint.
As an example, one morning in the pharmacy I had someone come into the pharmacy demanding their Warfarin. I said I would get on it but it would take a bit of time to check their profile and get it ready. Their response was "It's only Warfarin, it's no big deal, what's the worst that can happen with warfarin?". Now the person's tone and attitude irritated me so I told them exactly what the worst thing is with Warfarin. Uncontrolled bleeding and death. My manager was horrified.
...But it was the truth
Warfarin in a tablet is the same warfarin that is in rat poison. The tablets are just an exact dose which is tapered exactly to a person's needs. It keeps blood thin to prevent clots but not so thin that it leads to bleeding issues.
Ever since that day I've been a little more judicious in the words that I speak about medication
And guess what? Being careful with your words is also a command from the Bible. Sure it says to be honest as I pointed out above but it also says this:
“Let your conversation be always full of grace, seasoned with salt...
Colossians 4:6 (NIV):
And
“The words of the reckless pierce like swords, but the tongue of the wise brings healing.”
Proverbs 12:18 (NIV)
Are those verses contradicting the command to tell the truth? Of course not. However, they are saying a person should choose their words carefully. Words can help and words can harm, choosing the best response is crucial.
Just ask any husband who has been asked the question "Does this dress make me look fat". Now if you choose the "Yes" or "No" answer then you chose the wrong word. The question my wife is typically asking is "Do I look good in this dress" and a YES or NO is too quick and doesn't verify that the husband actually cares or is paying attention. How would I answer? Well, depends on if the dress looks good on her or not, the occasion and such. Something like "You would look fine in any of your dresses.... but that dress might be a little too brightly coloured for the event we are going to, or perhaps ... but that dress might be cumbersome for a less formal event". A response that helps her feel good about her choice, and shows I thought about the positive and negative with a bit of feedback. Of course if it is truly awful she might get an answer like "Uhm, it doesn't make you look flat but it really isn't flattering". (Yes, my wife does have a couple of those dresses, not my favorite).
In the Pharmacy setting... the whole truth isn't always helpful
Just like the person who asked "What's the worst that could happen" sometimes giving too much information can be just as bad as too little.
Let's look at Ibuprofen which is a readily available, fairly safe, fairly inexpensive, and very effective pain reliever for things for many many types of pain. It is on the WHO Essential Medicines List, it is put into aid relief packages, it is available without a prescription in most of the world and kept in global disaster relief stockpiles. It's use is widespread, commonplace and the number of people it has helped cannot be understated.
However, if you REALLY wanted me to tell you the worst side effects of Ibuprofen and wanted "The whole truth and nothing but the truth?". Well, I would probably point out the articles that come up every five or ten years about some person (typically a child because it makes a better headline) who got Toxic Epidermal Necrosis or TEN. What is TEN? Basically it is where your skin sloughs off, you are in a hospital getting transfusions, skin grafts, and treatment for severe pain for months. 30-50% chance of death even with hospitalization.
But is that information helpful or harmful?
On the one side you have a tiny risk of a severe problem and on the other side you have the almost guaranteed benefit of pain reduction. If my words keep you from getting an effective treatment with a real but very small risk of a problem ... is that a good thing?
And to make matters worse?
EVERY! medication I keep in the Pharmacy has the risk of allergies, interactions, side effects and such. That's the whole reason its prescription in the first place! Every medication I give out is balancing the potential for good VS the potential for a problem. In some cases like Ibuprofen the benefit outweighs the risk by such a large margin that people are allowed to buy it without a prescription in much of the world. A different but equally effective painkiller Vioxx was pulled from the market because....it had a much larger potential for problems
But why do we lie about prescriptions taking 15 minutes?
(Image source: Dall-e)
Honestly?
I refuse to say that and I cringe whenever I hear my front store staff or the owner say those words. I know they aren't true and I know why they aren't true and I know why it is said so common.
If I was to say why do prescriptions take 15 minutes?
Because Pharmacists are lazy
or possibly because
The patient doesn't want the real answer
But does the patient really want the honest answer?
I'll let you decide. I almost never say it will take 15 minutes. I give a different answer and it usually gets the customer mad at me. My go-to answer? I'll aim for 5 minutes but it could take much longer. Or perhaps. I have 3 people ahead of you, once I finish their prescriptions I'll do yours as quickly as possible. I hope for 15-30 minutes but I can take your number and call you when it is ready.
Now I understand that the customer just wants to know how long they will be sitting and waiting. They want to plan their day or the errands they have to do. They want to be in and out as quickly as possible and tell their wife/husband/kids/boss when they will be back to work/home/school, etc.
Hearing 15 minutes is (a) long enough that they don't think its going to be fast but (b) short enough that they don't think it is going to be too long. That's why many pharmacies give it out as a common answer to placate the customer.
Why I just can't give the 15 minute lie
As a Christian it just sits wrong with me to say something that isn't true. The honest answer is "I don't know how long". I do know that if you have one medication, no problems, and no interruptions I can usually have it done in 3 minutes. One minute to enter, one minute for the label to print and one minute to get it counted and labelled. If you have 5 prescriptions that 15 minutes is the absolutely minimum time I will need.
However, there are unknowns.
Counting 21 capsules is fast. Counting 720 Lithium Capsules (or Phenytoin)? That takes a lot longer.
What if I find a drug interaction? I'll need to think longer
What if I find a dangerous dose? I'll need to think longer
What if I find drug abuse?
What if the medication is out of stock?
What if the medication isn't covered by insurance?
What if I get interrupted by the phone?
What if I have 3 people who are all calling for my help
What if another person comes in with an axe demanding narcotics like 21 years ago?
- And sometimes I just can't read what the doctor wrote 😁
I just don't know what I'm going to find after I start working on the patients prescription. I can't even look at that prescription until after I've finished the person I'm working with.
Another question I hate answering
Sometimes I have to order medication in for someone and the person wants a guarantee that their medication will absolutely be in our store by a certain time the next day. Typically with the words "I only have enough for one day...I have to have it tomorrow by noon". Which puts me in a tough position. I can check the wholesale inventory which shows in stock. I know the delivery driver typically arrives at 10:00am. Most of the time it will be in our pharmacy on time and as promised.
- But what about the times the driver gave us the wrong order
- What about the time where there was a fatality on the freeway and traffic was backed up for hours?
- What about the time my driver was held up at gunpoint and had all the medication stolen?
There are many things that are just out of my control. I can't guarantee anything until the medication is in my hand and ready to go. I can be fairly certain but to promise something I don't have full control over?
Well, there is another bible verse for that one.
James 4:13–15 (NIV):
“Now listen, you who say, ‘Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money.’ Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes. Instead, you ought to say, ‘If it is the Lord’s will, we will live and do this or that.’”
Which more or less says: I can't control everything so don't make promises I can't keep.
Twisting Words and Half Truths
Lying doesn't come easy to me. Honestly is much easier as I never have to remember what I may have told anyone. Much easier to tell the truth. For me it is more telling the truth in a respectful way that is helpful and constructive. Following the rule "If you can't say anything nice, don't say anything at all". Sometimes that means framing words in such a way to highlight the positive and minimize the negative. I don't see that as being dishonest but rather a way of being respectful.
I'm also well aware that the exact opposite is true. Many people tell half the story and paint a picture that is misleading. Politicians are well known for this. Drug companies aren't much better. Hmm... I bet car salesmen, insurance agents, and investment planners are even more dishonest while telling the "truth" than the average person as well.
Do I try to frame the truth nicely? Absolutely. I would say that in my job its a necessity. I try to think of how I'd want the truth told to me. In a way that respects my agency and my intelligence without getting involved in minutia. Other people frame the truth differently. Trying to bend the words so that the person they are talking to views them in a better light. Personally I think the golden rule of "Do to others as you would have them do to you" fits with the truth. Tell the truth to others as you would want it put to you.
Black, White, Gray, and Silly
"Thou shall not lie" is a very black an white rule. "Let your yes mean yes" is also very black and white. Unfortunately the world is a very gray area. My viewpoint: Frame the words to tell the truth in the kindest most useful way.
But just for fun... Sometimes the pharmacy corporate offices treat people like morons. Unfortunately some people are.
Probably 20 years ago now I filled a prescription for a rectal suppository. As per usual I used the directions: "Insert one suppository rectally twice daily". I was reprimanded by the manager. The directions should be "Remove one suppository from the foil and hard plastic shell and then insert it rectally twice daily".
That made me pause.
It is true that you have to remove the medication from the packaging before you take it. By omitting details I wasn't truly telling them how to take their medication. My mind went to how painful it would be to insert something encased in hard plastic and aluminum foil into a sensitive area. Then hearing that there was a lawsuit and damages awarded it made me sad.
Omitting something can get you in trouble legally. Unfortunately the alternative is treating others as .... I guess I'll say "lacking" although perhaps a different word would be more fitting.
Just saying that to prove a point. Saying too little and your not telling the whole truth. Saying too much and you aren't being respectful. Finding the balance is the challenge.
If you ever come to my pharmacy?
Please don't ask how long the Prescription will take 😅 I know the "15 minutes" is a reassuring platitude but it's usually not an honest answer. As a side note: I usually write the time the prescription came in when its in line to be done. So, for those of you who call out "Do you know how long I've been waiting!".... My answer is "Yes" 🙂
I promise I will get to it just as quickly as I can.
....and I'll give you my honest opinion on how to use the medication
........and if you really want to know all the possible issues? Well, I'll talk to you about that too 😁
And that's my response to the Hive Learner prompt about "is omitting details lying". I'd love to get your feedback and thoughts. Love getting comments.
