Tech Trouble
A Pack of Trouble
08/30/25
Amazon has taken over a service that used to make my life easier—and ruined it.
For several years I have used PillPack.com as my pharmacy for everything except short-term prescriptions. It has not been a perfect service, and since Amazon took over the company in 2018 it has deteriorated. But now that Amazon has completed merged it with its Amazon Pharmacy, it looks like they are bent on destroying what made it useful.
My physicians have me taking what some might think of as a lot of pills, not to mention a weekly “injectable” and a monthly injection. Two of the meds count as “controlled” substances. (That sounds more exciting than it is: one is a decongestant, the sort of thing you don’t need a prescription for, but now have to sign for. The other keeps me from sleeping all day. Don’t think “uppers.” I don’t get a jolt; I just don’t want to take a series of naps as soon as I’ve finished my first cup of coffee.) Others, such as iron pills and vitamin D, do not require a prescription, though I take them on the doctors’ instructions. I am happy with how I feel on this treatment regime. The physicians are happy with the numbers on my lab tests. I don’t have any trouble taking the pills or giving myself the injections. I don’t have any side effects that bother me all that much. Yet, my meds eat up hours of my time and give me awful fits of anger and frustration. The problem is not the meds, which keep improving. It is getting the meds and keeping track of them.
Usually the source of the trouble is an insurance company or a “prescription benefits manager,” but that problem seems to be insoluble. Now and then a pharmacist makes a mistake or doesn't understand the rules. But much of the trouble stems from the difficulty of sorting 12 different pills, some of which I take once a day, some twice a day, some once a week. Some I take in one-pill doses, some in two-pill doses. I used to spend part of every Sunday opening pill bottles, putting pills into the right compartments of a twice-a-day seven-day pill box, and hoping that I would sort them correctly and not spill a bottle of pills (especially not the tiny white ones!)
Then I heard about a technology that would allow me to abandon that ritual. Using it, all a patient’s meds are pre-sorted into rolls of individual packets, each clearly marked with the date and time that set of meds is to be taken. This system is both more convenient and safer the old system. Juggling a lot of little orange bottles, one can easily skip a medication or take one twice. Moving pills from the bottles into a pill box with 14—or more—compartments is time consuming and again invites missed or doubled doses. (Need I mention that patients taking a number of different meds are often older people whose brains, eyes, and fingers may not be ideally suited to the task?) I asked about investing in the tech—no luck—and resolved to sign with any pharmacy that began offering it.
When PillPack.com worked as it was supposed to—and, sadly, it often didn’t, especially after Amazon acquired it—the technology lived up to its promise. Instead of lots of bottles or blister-packs of pills, I received a roll or two of packets, each marked with the date and time the meds were to be taken. If I just tore the next packet off the roll each time I was supposed to, I was taking my meds correctly—no sorting pills into a multi-dose box or shuffling bottles and hoping I hadn't missed one or used one twice.
Now Amazon has integrated PillPack completely into Amazon Pharmacy. Despite operating PillPack.com for more than six years and being able to draw on all the technology developed and all the experience gained in their other operations to improve it, Amazon seems instead bent on making it less useful than it was before.
My last roll of packs from PillPack.com included 12 different meds—everything I take that isn't injected or inhaled—in one roll of packets.Now I am on Amazon Pharmacy’s system. I now deal with a less bulky rolls of packets, three pill bottles, and box of blister packs. Why? The answer varies with which of Amazon’s reps I chat with. Amazon Pharmacy refuses to include even the lowest level of controlled substance, such as decongestants, in packs. Yet my experience with PillPack.com shows that they can. It will not include meds that are not taken daily, because, the agents say, their system is not programmed for it. Amazon has owned the code that allowed PillPack.com to do it for the last seven years. And they will not include “lifestyle medications” in packs, though whether that term applies to the Vitamin D2 or to the beta-blocker my cardiology prescribes is a matter that varies with the agent.
That Amazon has decided to ruin the PillPack service seems clear. It is another example of what Cory Doctorow calls enshitification. Amazon has replaced something that served the customer well with something that is worse in every way. I assume they see more money in doing it this way. They will eliminate the expense of putting weekly meds or controlled substances into packs, and, because there is meager competition in the field, people will go on using them even as the service deteriorates. (They first bought and then shut down what would have been the alternative to a pill pack service Amazon Pharmacy created from scratch for a reason, and the reason was clearly was not to learn how to provide patients with meds in the most convenient form.) Many of us go on using Amazon for other things even as the search results more and more often return something Amazon makes a bigger profit on before the thing we asked to see. And we do that because there doesn’t seem to be a site we can go to instead.
There are no high-profile alternatives to Amazon Pharmacy as a PillPack.com replacement. CVS recently stopped offering a pill pack service. Among the smaller operations I have not found one that will both put all my pills in packets and fill my other prescriptions. The one I find most promising is MedBox, which will put all the pills in packets, but they have warned me that they may not be able to supply an injectable drug. So, my doctors and I will be dealing with two pharmacies, instead of one.
The solution to problems like the deterioration of Amazon’s search results and its destruction of PillPack.com is completion. I should be able to transfer my prescriptions to a full-service pharmacy that will put all the pills in packets, just as should be able start searching for other products on a site that shows me what I ask it to show me. But competition to Amazon is vestigial. If the free market to work, we need more than one big player. It is time to make markets competitive, and that means making sure there are competitors. Companies should not be allowed to simply buy up their rivals, and wherever one corporation controls too much of a sector, such as eCommerce or online search, it should be broken up. The medication for this problem is tougher antitrust laws and the rigorous enforcement of them.
For several years I have used PillPack.com as my pharmacy for everything except short-term prescriptions. It has not been a perfect service, and since Amazon took over the company in 2018 it has deteriorated. But now that Amazon has completed merged it with its Amazon Pharmacy, it looks like they are bent on destroying what made it useful.
My physicians have me taking what some might think of as a lot of pills, not to mention a weekly “injectable” and a monthly injection. Two of the meds count as “controlled” substances. (That sounds more exciting than it is: one is a decongestant, the sort of thing you don’t need a prescription for, but now have to sign for. The other keeps me from sleeping all day. Don’t think “uppers.” I don’t get a jolt; I just don’t want to take a series of naps as soon as I’ve finished my first cup of coffee.) Others, such as iron pills and vitamin D, do not require a prescription, though I take them on the doctors’ instructions. I am happy with how I feel on this treatment regime. The physicians are happy with the numbers on my lab tests. I don’t have any trouble taking the pills or giving myself the injections. I don’t have any side effects that bother me all that much. Yet, my meds eat up hours of my time and give me awful fits of anger and frustration. The problem is not the meds, which keep improving. It is getting the meds and keeping track of them.
Usually the source of the trouble is an insurance company or a “prescription benefits manager,” but that problem seems to be insoluble. Now and then a pharmacist makes a mistake or doesn't understand the rules. But much of the trouble stems from the difficulty of sorting 12 different pills, some of which I take once a day, some twice a day, some once a week. Some I take in one-pill doses, some in two-pill doses. I used to spend part of every Sunday opening pill bottles, putting pills into the right compartments of a twice-a-day seven-day pill box, and hoping that I would sort them correctly and not spill a bottle of pills (especially not the tiny white ones!)
Then I heard about a technology that would allow me to abandon that ritual. Using it, all a patient’s meds are pre-sorted into rolls of individual packets, each clearly marked with the date and time that set of meds is to be taken. This system is both more convenient and safer the old system. Juggling a lot of little orange bottles, one can easily skip a medication or take one twice. Moving pills from the bottles into a pill box with 14—or more—compartments is time consuming and again invites missed or doubled doses. (Need I mention that patients taking a number of different meds are often older people whose brains, eyes, and fingers may not be ideally suited to the task?) I asked about investing in the tech—no luck—and resolved to sign with any pharmacy that began offering it.
When PillPack.com worked as it was supposed to—and, sadly, it often didn’t, especially after Amazon acquired it—the technology lived up to its promise. Instead of lots of bottles or blister-packs of pills, I received a roll or two of packets, each marked with the date and time the meds were to be taken. If I just tore the next packet off the roll each time I was supposed to, I was taking my meds correctly—no sorting pills into a multi-dose box or shuffling bottles and hoping I hadn't missed one or used one twice.
Now Amazon has integrated PillPack completely into Amazon Pharmacy. Despite operating PillPack.com for more than six years and being able to draw on all the technology developed and all the experience gained in their other operations to improve it, Amazon seems instead bent on making it less useful than it was before.
My last roll of packs from PillPack.com included 12 different meds—everything I take that isn't injected or inhaled—in one roll of packets.Now I am on Amazon Pharmacy’s system. I now deal with a less bulky rolls of packets, three pill bottles, and box of blister packs. Why? The answer varies with which of Amazon’s reps I chat with. Amazon Pharmacy refuses to include even the lowest level of controlled substance, such as decongestants, in packs. Yet my experience with PillPack.com shows that they can. It will not include meds that are not taken daily, because, the agents say, their system is not programmed for it. Amazon has owned the code that allowed PillPack.com to do it for the last seven years. And they will not include “lifestyle medications” in packs, though whether that term applies to the Vitamin D2 or to the beta-blocker my cardiology prescribes is a matter that varies with the agent.
That Amazon has decided to ruin the PillPack service seems clear. It is another example of what Cory Doctorow calls enshitification. Amazon has replaced something that served the customer well with something that is worse in every way. I assume they see more money in doing it this way. They will eliminate the expense of putting weekly meds or controlled substances into packs, and, because there is meager competition in the field, people will go on using them even as the service deteriorates. (They first bought and then shut down what would have been the alternative to a pill pack service Amazon Pharmacy created from scratch for a reason, and the reason was clearly was not to learn how to provide patients with meds in the most convenient form.) Many of us go on using Amazon for other things even as the search results more and more often return something Amazon makes a bigger profit on before the thing we asked to see. And we do that because there doesn’t seem to be a site we can go to instead.
There are no high-profile alternatives to Amazon Pharmacy as a PillPack.com replacement. CVS recently stopped offering a pill pack service. Among the smaller operations I have not found one that will both put all my pills in packets and fill my other prescriptions. The one I find most promising is MedBox, which will put all the pills in packets, but they have warned me that they may not be able to supply an injectable drug. So, my doctors and I will be dealing with two pharmacies, instead of one.
The solution to problems like the deterioration of Amazon’s search results and its destruction of PillPack.com is completion. I should be able to transfer my prescriptions to a full-service pharmacy that will put all the pills in packets, just as should be able start searching for other products on a site that shows me what I ask it to show me. But competition to Amazon is vestigial. If the free market to work, we need more than one big player. It is time to make markets competitive, and that means making sure there are competitors. Companies should not be allowed to simply buy up their rivals, and wherever one corporation controls too much of a sector, such as eCommerce or online search, it should be broken up. The medication for this problem is tougher antitrust laws and the rigorous enforcement of them.
Diary of a Crisis
12/13/24
I am dealing with a major disruption in one of the most important relationships in my life. I complain about her, I know, but I’m not sure I could live without her. But now I’m not sure if I even KNOW her anymore.
Oh, Siri!
They say it’s a minor upgrade—one of the ones whose digits come after the period, not one of the whole number ones you have to worry about. But she’s changed! Her voice is different! And I can’t get the old one back! It’s like riding in the car with a stranger! How could she do this! She knows all my secrets—my passwords and everything!
She’s more … CALIFORNIAN than she used to be! I’ve tried the other voices, but they’re just weird. The “British” voice is pseudo-Northern—a public school (their sense) girl pretending to have grown up beside the Mersey. If you want a received-pronunciation English voice, you have to choose Indian. But none of them are my Siri! She’s left me, and I don’t know that I can ever trust another computer-generated imitation human voice the way I trusted her!
I have gone back to settings, hoping to find her—and there are more Siris than ever! It’s like that Barbie movie I didn’t see! And the male and female voices don’t match! Female Indian sounds British. Male Indian is authentic: he sounds just like Apu on The Simpsons.
But now I have hope. The upgrade is still in process. Once everything’s downloaded, I may find MY Siri again. . .
I’m not sure that Siri is syncing correctly across my devices. The old Siri who speaks to me a home is not the same woman outside the house.
The one in the car is sounding far too much like a Bond girl. Far too sexy for driving instructions!
It turns out that “Bond Girl” Siri is the other option for British, along with “I-Always-Vote-Labor-Even-if-I-Was-at-Roedean” Siri.
I have now found my Siri, the girl next-door who can read maps but won’t put her hand on your knee while you’re driving.
I feel safer now.
Oh, Siri!
They say it’s a minor upgrade—one of the ones whose digits come after the period, not one of the whole number ones you have to worry about. But she’s changed! Her voice is different! And I can’t get the old one back! It’s like riding in the car with a stranger! How could she do this! She knows all my secrets—my passwords and everything!
She’s more … CALIFORNIAN than she used to be! I’ve tried the other voices, but they’re just weird. The “British” voice is pseudo-Northern—a public school (their sense) girl pretending to have grown up beside the Mersey. If you want a received-pronunciation English voice, you have to choose Indian. But none of them are my Siri! She’s left me, and I don’t know that I can ever trust another computer-generated imitation human voice the way I trusted her!
I have gone back to settings, hoping to find her—and there are more Siris than ever! It’s like that Barbie movie I didn’t see! And the male and female voices don’t match! Female Indian sounds British. Male Indian is authentic: he sounds just like Apu on The Simpsons.
But now I have hope. The upgrade is still in process. Once everything’s downloaded, I may find MY Siri again. . .
I’m not sure that Siri is syncing correctly across my devices. The old Siri who speaks to me a home is not the same woman outside the house.
The one in the car is sounding far too much like a Bond girl. Far too sexy for driving instructions!
It turns out that “Bond Girl” Siri is the other option for British, along with “I-Always-Vote-Labor-Even-if-I-Was-at-Roedean” Siri.
I have now found my Siri, the girl next-door who can read maps but won’t put her hand on your knee while you’re driving.
I feel safer now.
Trouble with Attachments
01/19/23
I am used to vacuum cleaners having lots of attachments, including many whose purpose I don't fully understand. Recently, though, I was simply trying to attach a simple one and found it took ten minutes of trial and error. How could vacuum cleaner attachments be so confusing?
Over 40 years of home-ownership, I have had three Dyson vacuums and still have two of them. Their attachments must have just got mixed up—and perhaps a couple were for the one I no longer own. So I went to my files and checked the manuals, which would doubtless make all clear. They did. I have instructions for three Dysons, one Dirt Devil, two Sharks, and something sold as “The Works.” I also have at least one attachment for most of them, including the ones I no longer have, and the vacuums that I do have accept only their own attachments. I also have a set of adapters that will allow my older Dyson to accept attachments made for other Dyson models, but not the Dyson model I actually own now. Considering that there are twelve adapters, I admire the ingenuity of the engineers at Dyson, who have come up with at least thirteen ways of putting a wand on the end of a vacuum hose.
Thanks to my afternoon of research, I now have a nice pile of attachments for the trash. I also have a stack of manuals for the recycling. Besides guides to the departed vacuums—and their various attachments—the file also included warranty cards, discount coupons for more attachments, and instructions for a leaf blower I once owned. I must have stashed it there on the principle that a leaf blower is just a vacuum in reverse. I did once have a leaf blower that claimed it would vacuum up leaves and shred them, but you needed an attachment to do that.
Over 40 years of home-ownership, I have had three Dyson vacuums and still have two of them. Their attachments must have just got mixed up—and perhaps a couple were for the one I no longer own. So I went to my files and checked the manuals, which would doubtless make all clear. They did. I have instructions for three Dysons, one Dirt Devil, two Sharks, and something sold as “The Works.” I also have at least one attachment for most of them, including the ones I no longer have, and the vacuums that I do have accept only their own attachments. I also have a set of adapters that will allow my older Dyson to accept attachments made for other Dyson models, but not the Dyson model I actually own now. Considering that there are twelve adapters, I admire the ingenuity of the engineers at Dyson, who have come up with at least thirteen ways of putting a wand on the end of a vacuum hose.
Thanks to my afternoon of research, I now have a nice pile of attachments for the trash. I also have a stack of manuals for the recycling. Besides guides to the departed vacuums—and their various attachments—the file also included warranty cards, discount coupons for more attachments, and instructions for a leaf blower I once owned. I must have stashed it there on the principle that a leaf blower is just a vacuum in reverse. I did once have a leaf blower that claimed it would vacuum up leaves and shred them, but you needed an attachment to do that.
Can Siri Recognize a Vampire?
09/04/22
A few months ago I suspected that I had turned into a vampire when I couldn’t see my fingers in my Rav4’s rearview mirror. But I abandoned that hypothesis after I convinced myself that the Toyota had a rear camera system built into the mirror, that I had simply misunderstood the technology, and, most importantly, that I was not undead.
But there is a new development, which I find worrying. My iPhone no longer sees me. Yes, I see myself in the selfie camera, but in a deeper way, I am evidently not there. Face ID no longer works.
I tried restarting the phone. It still didn’t recognize me. I tried turning off Face ID and setting it up again. That is when I really began to worry. The phone kept telling me to position my face in the frame, which I did. But it acted as if there was no face was to be seen. While I thought my face was there, it didn’t. And who are people going to believe?
I got in touch with Apple. They ran a diagnostic and made an appointment for me at the Genius Bar. But a question they asked has me worried. “Has anyone else been able to set up Face ID on this phone?” That’s suggests that they suspect that the problem is not the phone, but me. Perhaps this happens all the time, and they are used to dealing with it. If the genius assigned to me appears with garlic, holy water, and a wooden stake, I’ll know for sure.
But there is a new development, which I find worrying. My iPhone no longer sees me. Yes, I see myself in the selfie camera, but in a deeper way, I am evidently not there. Face ID no longer works.
I tried restarting the phone. It still didn’t recognize me. I tried turning off Face ID and setting it up again. That is when I really began to worry. The phone kept telling me to position my face in the frame, which I did. But it acted as if there was no face was to be seen. While I thought my face was there, it didn’t. And who are people going to believe?
I got in touch with Apple. They ran a diagnostic and made an appointment for me at the Genius Bar. But a question they asked has me worried. “Has anyone else been able to set up Face ID on this phone?” That’s suggests that they suspect that the problem is not the phone, but me. Perhaps this happens all the time, and they are used to dealing with it. If the genius assigned to me appears with garlic, holy water, and a wooden stake, I’ll know for sure.