A violent incident in the pharmacy prompted Terry Maguire to go into ‘teacher mode’
When I looked out from the dispensary just after opening I noticed him seated, quiet, menacing almost, in the chair by the make-up stand. A dark, small, looming figure, he was sitting forward, face-down, anorak hood up over his head. He wore a black face-mask, so it took me a moment to establish who it was. I challenged him to remove the mask, joking that he was “well dressed for robbing the pharmacy”. Keeping his head down, he momentarily lifted the mask to reveal an ashen, expressionless face, confirming his identity. I prepared his daily methadone dose and called him in. Most of our male methadone clients wear some form of head and face covering and I have always supposed this was to minimise unfriendly third-party recognition. It is true that in the big, bad world they inhabit, fractious transactional relationships are too easily created.
He had been with us about a month and initially came with his partner; we were told they were a couple. Initially, they were ideal methadone patients; came in quietly, waited until called, took their observed dose, and left. Two days previously they arrived at different times, she sporting an impressive black eye and accompanied by a social worker.
In the counselling room he said little, drank the green liquid in one swallow, and then asked about her; had she been in? I reminded him that I could not discuss another client and he briskly left.
The morning took on its usual dispensary work pattern. A few hours later, she arrived with a social worker, a tall African man. They both took a seat while I prepared her dose. I had just called her into the counselling room when I was aware of a cowled and masked figure running from the main door. She had reached the entrance to the dispensary and as she spotted him, she emitted a high-pitched screech. Rather than go into the counselling room, she ran behind me and into the dispensary as the social worker jumped to his feet. The social worker wasn’t attempting to stop the assailant; he was acting instinctively and awkwardly blocked his progress.
A knife was thrust at the social worker’s throat as he was forced back against the pharmacy shelves, sending stock onto the floor. He was told firmly that if he continued to follow her around, he would be shot. Petrified, the social worker kept his hand up as I ushered her and my pharmacy technician into the corridor to the store and closed the key-coded security door. With them safe, I then did something that I seem to do in high-risk and dangerous situations; I adopted the teacher role. My mother, a teacher for 50 years, was adept at controlling rowdy pupils and at times of stress for some inexplicable reason, I mimic her. With a firm, strong voice, I named him directly as I walked slowly and purposefully towards him. I told him to immediately stop threatening the social worker. As I looked him in the eyes, I told him this was unacceptable behaviour and he should be ashamed of himself. I had no plan; this was me mimickin my mother and I had no idea how it would finish.
He withdrew his hold and backed off. The social worker, greatly relieved, slid down onto a chair as the knife was skilfully slipped into the back of his trousers and he turned his attention to me. He protested, with some attempt at justification; she had reported him to the police. I told him that was irrelevant and he had no right to come into my pharmacy aggressively welding a knife and threatening a man who was only doing his job. A voice in my head whispered that I should back off, this was dangerous and I might get stabbed; die, even. But the teacher mode prevailed. I was now a few feet from him and between him and the social worker. I instructed him to leave the pharmacy and confirmed I would be calling the police. Obediently, he left and ran off. I followed to the door and turned the deadlock then checked if the social worker was physically injured; he wasn’t, just very shocked. I opened the security door, letting both out and I rang the police who were delighted that, in what was possibly a first for West Belfast, I had the suspect’s name and address. Then, as professionally as I could, I provided her with a daily methadone dose.
The assaulted social worker was joined by two colleagues who had been waiting in the mini-bus they arrived in and to which she was returned for safety. I continued as best I could with quotidian pharmacy tasks. Over the half-hour it took the police to arrive, the social worker’s colleagues talked a lot in the way social workers talk, but the assaulted man just sat, silent, staring at the floor. Eventually, the police were on the scene, took statements and a copy of the CCTV recording, which to my astonishment gave a full and impressive cinematic record of the event. Normally, the main action happens in a corner blind-spot. The police informed us that the assailant was in custody. This news brought surprising relief, given his current state of mind, and the fact that I involved the police, I did worry about a reprisal.
The next day a police officer, with appropriate paperwork, arrived to collect his methadone and this continued for two more days, when he was transferred to prison and we had a discussion with the prison pharmacist on methadone dosage. The same pharmacist rang a week later, telling me the great news that he was being released on bail and would be returning to us for his daily dose. I made it plain and clear — in words that would never qualify in any sense as professional — that this would not be happening. It then became clear to me that the prison pharmacist had no idea why he was incarcerated and where I did not fill in any details, my response was sufficient to ensure he would need to arrange methadone supplies at a different pharmacy.
There is so much wrong in the lives of those addicted to drugs and alcohol. The current social contract is certainly compassionate and understanding and, for some who embrace help, lives can and are turned around. But for many, this will not happen and cannot happen, as the harm done from growing up and living in adverse circumstances and making wrong choices is just too damaging. I don’t know what, if any, my teacher mode intervention achieved and I wonder, perhaps fanciful in the extreme, if a more authoritarian, assertive voice in childhood, fixing boundaries of behaviours, might have resulted in better choices and more positive decisions later in life. Perhaps this is just nonsense. What is clear, however, is that she is a victim of ‘domestic violence’ and if she returns to this relationship, which given her dire circumstances might actually happen, it is likely she will lose her life.
Terry Maguire owns two pharmacies in Belfast. He is an honorary senior lecturer at the School of Pharmacy, Queen’s University Belfast. His research interests include the contribution of community pharmacy to improving public health.