The pharmacist who let me go without a word

It was a Monday. I walked to the pharmacy, in no rush because it wasn't an emergency. I was already getting there as soon as I could, only just back from a trip. I had cleaned my wound the day before but it was not looking good, taking on a pale yellow shade between the red edges, and given the tool responsible, I wanted to make sure it was not getting infected.

That pharmacy wasn't the one I went to most of the time, but it had the distinctive advantages of being on my way and having already registered my health insurance cards. When I entered, two pharmacists were already busy with clients, so I remained to the side to wait. That's when a third pharmacist appeared, in the process of putting on her coat and apparently ready to leave. Contrary to my expectations, she motioned for me to come to her countertop ; I wasn't going to refuse, especially since my question would only take a few seconds.

I took a deep breath, to suppress the light feeling of shame and the much greater apprehension that were overwhelming me. I lifted my sleeve and showed her my wrist, opting for a voluntarily neutral wording: "I got a cut here and I wanted your opinion: is it getting infected?"

The pharmacist, almost done putting on her coat, leaned forward to examine my wound: "did you clean it?" I said yes, but only three days later. Without asking how I'd gotten that wound ; without asking what kind of circumstances had kept me from cleaning it right away ; without any additional question, the pharmacist let me go with a "leave that uncovered, no need for cream or anything".

My wound did not, in fact, get infected. And I haven't harmed myself again since, at least not physically. I mentioned it to my psychiatrist when I saw her for my monthly appointment and I was even able to start therapy, for free, last week. But that pharmacist didn't know me. Since I hadn't asked for prescription-only medication, I hadn't needed to show her my health insurance card ; which means that she had no way of knowing if I'd ever been to this pharmacy before, or whether I was on any kind of medication. She should have asked me questions.

My wound was clearly the result of self-harm. It was such a typical one, so easy to identify: two or three cuts on my left wrist, red, deep. Most people are right-handed ; most people who self-harm are women, young ones at that ; most self-harm, especially the first-time kind, takes the form of cutting on the arms.

I didn't need someone to suggest I talk to my general practitioner, because she already knew about my struggles and supported me really well. I didn't need someone to refer me to a psychiatrist, because I had been seeing one for the past four years. I didn't need someone to help me identify why I had harmed myself: I knew precisely the circumstances of the emotional distress that had submerged me that night, I knew perfectly well what negative coping technique I had used, and I had already exhausted that very distress with the precious help of my husband.

But that's exactly what a young person in a situation different than mine would have needed. She would have needed someone to take care of her, to check that she was being looked after professionally, to talk to her confidentially in a soft but firm voice... To not let this go. To not ignore the harm that she had inflicted upon herself, and to ask her questions, as uncomfortable as it might be for both her and the professional facing her. "How did you get wounded? When and what with? Did you intentionally harm yourself? Was it the first time? Do you have someone trustworthy to talk to, did you tell anybody about this? Does your GP know? Who are they? Are you seeing a psychiatrist or a psychologist? Are you currently on medication? Which one and for how long? Was it recently modified?" Etc.

The questions to be asked can be numerous, depending on the answers. And of course you can never know whether the person is answering honestly. But someone used to self-harm and determined to hide it, to lie about it, would most likely not go ask a pharmacist about their wound. So it would rather be the case of someone in my situation... or someone who had just self-harmed for the first time, thereby even less likely to be already getting professional help.

Silence kills. And when it doesn't kill, it mutilates. The pharmacist should have said something, she should have expressed worry as a healthcare professional, if not as a human being. I don't personally resent her, but I am indeed criticizing her reaction -- in this case, her lack thereof -- because it endangered a life. I am questioning her professionalism. The potential of inaction, in terms of mental health, is huge: it is everyone's duty to care, but it is even more that of healthcare professionals, psychiatry-related or not.

Don't remain silent. Don't stay alone. Speak, ask questions. That's how you move forward in life and that's how you protect the people you love.