Cities 07

The health of a city relies somewhat heavily on the public’s access to health insurance and the promotion and exposure to public health. This is why I thought it would be interesting to analyze Wirth’s idea of secondary interactions in two different pharmacies. I was interested in the interactions between both the pharmacists and the patient (customer), especially regarding those patients lacking health insurance and the interactions between patient and patient. The first pharmacy I went into was inside Hennepin County Medical Center (701 Park Ave) in Minneapolis--the hospital pharmacy. The pharmacy opened promptly at 9am and I entered at about a couple minutes after. The first thing I noticed was the excessive use of signage posted everywhere. Mostly hand crafted, they read out: “Please wait here till cashier calls you,” “no cell phone use”, and “use only one line on Saturday/Sunday.” There was one neon sign that scrolled through the hours of the pharmacy. The room, attached to the rest of the hospital, was fairly large with 6 aid-windows. Only one was available for use. I assumed this was because it was 9am on a Sunday morning. The lighting was dull, but sufficient. The waiting area where I took position was covered with magazines and debris lie under several of the chairs. There were six people in the pharmacy when I got there; two were getting ready to leave, one was sleeping, and the remaining three were waiting for the pharmacists to call their names.

There appeared to be two different pharmacists and one, Tom, was more helpful than I could even fathom a pharmacist to be. I was there for about an hour and a half and I (conspicuously) tried to listen as best as I could to the conversation that took place between the pharmacists and the patient (is that bad? :S). Of course some conversation was skewed because the privacy windows indeed provided some muffling, but overall I felt I was able to guess the general tone of conversation. My favorite conversation was between Tom and a man who didn’t have insurance. He came in almost hostile—apparently the doctor he had just visited threatened to call security on him because he was requesting that he have a certain medication and he felt like the doctor was saying no. Anyway, it turned out that the doctor had indeed prescribed the drugs that this man wanted but for some reason or another there had been a misunderstanding about it. The pharmacist of course was the one who had to figure this out. Later the man (patient) apologized profusely for the trouble that he had caused, but the most amazing thing was that the pharmacists just showed such sincere concern that he (the patient) have what he thought he needed. I’m not entirely sure how the situation turned out the way it did, being that he didn’t have insurance, but he walked away (after about five minutes of waiting) very relaxed and gleeful that he had his medications. There was also another situation where a woman came in without prescription drug health insurance and the pharmacist patiently explained that Medicare paid for her doctor’s visits but that prescription drugs were not included. Not only did he explain the situation to her but gave her a specific name of a woman (Mary I think) who she could call to inquire about an ‘upgrade’ on health insurance so as to have prescriptions covered by her insurance. There was a line at this point in my visit and I thought it was very great of the man to be persistent--so that the woman (patient) would be fully supported. Many of the other patients new Tom by name and I think about 1 in 3 were lacking of health insurance…no one however, was refused their medications.

It was interesting that the patients all came in pairs (except two people) and as one went to the window to obtain their medications the other waited in the waiting area (where I was at) patiently. All of the patients though got a long really well. I’m not exaggerating when I say that everyone that came in interacted through speech with someone else. Some asked specific questions, others just general conversation.

As I was walking to the next pharmacy, I could not help but make conversation with the several people I passed. I got lost on the way but was steered in the correct direction by a passerby—I didn’t say anything—clearly he could sense my confusion. I walked to the Walgreens on Nicollet Mall to be greeted to the fact that they are closed on Sundays. I ended up at the Walgreens by my house on Chicago and 43rd street. The store is huge. There are a lot of bright lights and a stale odor fills the entire place. The pharmacy is fairly large but it is hidden amongst the rest of the store, which carries consumer products ranging from nail polish to cereal. The customers seem to be more interested in the ‘super market’ part of the store and as I made my way to the pharmacy area I realized that people were still communicating with one another about where items were and how this product “affected me well.”

I sat in a chair near the large window and waited. (One large window compared to 6 little ones). I stayed there the same amount of time—1.5 hours. In this time, about the same amount of people came in as HCMC, however their length of stay was much longer. Those that came in without health insurance were put into another line and their “issues” seemed more like catastrophes. The pharmacists seemed tired and it was through the communication of the customers/patients themselves that I felt somewhat at ease being there.

As I spent these three hours of observation I realized that I had a lot to say to Wirth about cities. He seems to characterize city dwellers as competitive and uncaring. I saw quite the opposite today however. Of course the pharmacist at the big corporation seemed a little bit like that, but how awful to use one person to generalize an entire city, or corporation for that matter, (although I fear prior interactions led me to believe that to be true of most corporations). Anyway, the fact that Wirth associates city interactions as secondary rather than primary contacts in the sense of kinship may be true. But the fact that the interactions and relationships are sincere is something I don’t think Wirth would agree with. The fact that people took time to interact with one another…help one another…notice that I needed help and act on it…show a lot of selfless interaction. Wirth states, “Typically our physical contacts are close but our social contacts are distant” (100). I felt (feel) that there is a large social community within the city and where there is distance among social interactions there lies also, quite a lot of communion in others. The pharmacists at HCMC knowing the patients names for example—even those without insurance! :)

I thought it would be interesting to take a non-corporate pharmacy and compare it to a large corporation because I agreed with Wirth’s statement that “the advantage that the corporation has over the individual entrepreneur and the partnership in the urban-industrial world derives not only from the possibility it affords of centralizing the resources of thousands of individuals or from the legal privilege of limited liability and perpetual succession, but from the fact that the corporation has no soul” (100). Although I do believe this is true I realized while I was carrying out the ethnograph that it was hard for me to come to this conclusion with this one experiment solely. The fact that I had a bad feeling about one pharmacist that worked in a corporation could correlate to the fact that corporations are “insensitive, soulless” but I can’t conclude that. The reason I feel like I can make more conclusive decisions/thoughts about the city dweller is because I interacted with 50-75 times more people (citizens). Just thought I wanted to clarify that!