Monday, May 31, 2010

Memorial Day, 2010

The lawyer from South Dakota

On memorial day, veterans graves across the country are honored with wreaths and flags. But some veterans have no graves to honor, and can only be remembered.



Lieutenant Commander John C. Waldron, U.S.N.


He & his men changed the course of World War II in the Pacific, and didn't live to know it.

He was a lawyer, born in Fort Pierre, South Dakota. His father was descended from English settlers, his mother was a Sioux Indian.

He was married, with 2 daughters.

He was admitted to the state bar in South Dakota, but rather then going into practice decided to join the U.S. Navy. He was chosen to be a pilot, in the new field of naval aviation.

He trained to fly torpedo planes (no longer in use). Their goal was to fly close enough to an enemy ship to drop a torpedo into the water, then get away as fast as possible. This was a difficult job. It required the planes to fly in a low, straight line as they approached the enemy, making them easy targets for enemy fighters and anti-aircraft.

Waldron was a good pilot. He was chosen to teach at Annapolis, and later Pensacola. He flew planes off 1 battleship and 3 carriers.

He and his wife held parties for other pilots at their Norfolk home. He was very proud of his little girls. Some pilots remembered being taken to his daughters' darkened bedroom and asked "Did you guys ever see such pretty little girls?"

With war looming in the Summer of 1941, Waldron and his men were assigned to the aircraft carrier U.S.S. Hornet, in the Pacific theater.

He was determined. He once told his pilots that "if we run out of gas, we'll piss in the tanks." He wasn't looking for glory, or to become a martyr, or a hero. He was just doing his job.

On the morning of June 4, the Hornet was somewhere off Midway island, placed there to defend against the massive Japanese force sent to capture the Pacific base.

Waldron likely had few illusions about his chances. Although his men were well-trained, their "Devastator" torpedo bombers were already obsolete. The new "Avenger" planes were much better, but only beginning to roll out of the factories. And with the enemy coming, they had to make do with what they had. Before the battle he called his men together and said "If there is only one plane left to make a final run in, I want that man to go in and get a hit."

The Japanese "Zero" fighter was a lethal weapon. Though poorly protected, it was quicker and more maneuverable than it's American counterparts. And it was flown by some of the best pilots in the world.

On the morning of June 4, 1942, Waldron led Torpedo Squadron 8 off the Hornet. He had orders to search for the Japanese in a specific area, but had a hunch (he called it his "Sioux intuition") that the heading he'd been told to follow was wrong. He disobeyed orders, and it turned out his intuition was correct.

Waldron led his 15 planes straight to the enemy fleet. Forced to fly straight & low to aim their torpedoes, they were sitting ducks as the Zeroes swooped down and destroyed them one by one. Out of 30 men, there was only one survivor, Lt. George Gay. He saw Waldron stand up in his plane as it burst into flames, just before his own plane was shot out from under him. They didn't get a single hit.



The 15 pilots of Torpedo Squadron 8, photographed in May, 1942. Waldron is standing, 3rd from left. Lt. George Gay, (circled, 1st row) is the only man in the picture who survived.

In a few minutes all the planes of Torpedo Squadron 8 had vanished beneath the Pacific, leaving only Lieutenant Gay hiding from the Zeros under his flotation device. It was a disaster for the Americans.

But unbeknownst to all but Lt. Gay, they changed the course of the Pacific war.

The deadly Zeroes were now at sea level, on the prowl for more torpedo planes. But the next American wave, this time of dive bombers, was high above. They might have been easy targets, too. But as they came down the Zeroes were no longer in a position to defend their fleet, and couldn't gain altitude in time to stop the bombers. Between 10:20 and 10:25 a.m that morning the Japanese lost 3 of their 4 aircraft carriers to the bombers. The last carrier followed them a few hours later.

The loss of the four carriers, with their planes, pilots, and crews, was a blow the Japanese navy never recovered from. The war went on for 3 more years, but the tide was turned by the sacrifice of a group of men, led by a 41-year old lawyer from South Dakota.

A
ll my readers, no matter what country they're in, owe their freedom to soldiers in all military branches. So remember them today.


The fallen from Torpedo Squadron 8. Their only grave marker is the blue Pacific water.

Lt. Commander John C. Waldron
Lt. Raymond A. Moore
Lt. James C. Owens, Jr.
Lt.(jg) George M. Campbell
Lt.(jg) John P. Gray
Lt.(jg) Jeff D. Woodson
Ens.William W. Abercrombie
Ens. William W. Creamer
Ens. Harold J. Ellison
Ens. William R. Evans
Ens. Henry R. Kenyun
Ens. Ulvert M. Moore
Ens. Grant W. Teats
Robert B. Miles, Aviation Pilot 1c
Horace F. Dobbs, Chief Radioman
Amelio Maffei, Radioman 1
Tom H. Pettry, Radioman 1
Otway D. Creasy, Jr. Radioman 2
Ross H. Bibb, Jr., Radioman 2
Darwin L. Clark, Radioman 2
Ronald J. Fisher, Radioman 2
Hollis Martin, Radioman 2
Bernerd P. Phelps Radioman 2
Aswell L. Picou, Seaman 2
Francis S. Polston, Seaman 2
Max A. Calkins, Radioman 3
George A. Field, Radioman 3
Robert K. Huntington Radioman 3
William F. Sawhill, Radioman 3

Sunday, May 30, 2010

Stereotypes

I hate them.

There are stereotypes about religions, races, ethnicities, doctors, nurses, etc. And they're usually WRONG.

BUT

When I get called into the hospital on a weekend, to see a guy in his 40's.

Who's still living with his mother.

Who brings in Dungeons & Dragons handbooks to read.

And the complete "Star Trek - Deep Space 9" collection on DVD.

And sets up some Star Wars action figures on the bedside table.


Then, dude, I'm reminded that all stereotypes, somewhere along the line, have some basis in fact. Even if it's just one person. Like you.

Personally, I think Boba Fett would be more likely to kick your ass than think you're cool.

And yes, ladies, believe it or not, he IS available.


Addendum- June 2, 2010. I had no idea how many nerves this post would touch, and am genuinely sorry. No offense was intended. Please see my comment below for more details.

Saturday, May 29, 2010

Insurance premiums at work

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mr. Shakes: "Yeah, I see you for epilepsy, and I missed my medication this morning, and I just had a seizure."

Dr. Grumpy: "Okay, have you taken another dose?"

Mr. Shakes: "Yeah."

Dr. Grumpy: "Good. So are you doing okay now?"

Mr. Shakes: "Yeah, I'm fine. I feel good. I'm going to go over to ER after the game."

Dr. Grumpy: "Why? It sounds like you don't need to. Are you back to normal?"

Mr. Shakes: 'Absolutely. But I wanna go get checked out."

Dr. Grumpy: "Okay, but..."

Mr. Shakes: "I'M GOING TO ER, DAMN IT!"

(hangs up)

May 29, 1914




If you read the popular stuff, you'd think there were only 3 major shipwrecks of the 20th century: Titanic, Lusitania, and Andrea Doria. Obviously, there are many more, even if you exclude 2 worldwide conflicts in the last 100 years. The worst peacetime shipwreck in history, the Dona Paz (Philippines), took 4,375 lives as recently as 1987. And I bet you've never heard of it.

Trans-Atlantic crossings have always been critical to both sides of the Atlantic (look at the chaos caused by the recent Icelandic volcanic eruption). Although the giant liners of Cunard and White Star are best remembered, they were by no means alone. Ships were constantly coming and going, carrying passengers and freight, both ways across The Pond.

Although less glamorous than the liners that sailed in & out of New York, there were many busy ships that called on the Canadian ports. One was the Empress of Ireland, which in 1914 was serving the Quebec City to Liverpool route.

Early this morning, 96 years ago, the Empress was outbound from Canada. She was heading northeast on the St. Lawrence River. It was 2:00 a.m., and most of the passengers were sleeping.

In a thick fog, the Norwegian coal-carrier Storstad struck the Empress on the starboard side. The damage was extensive. There was only limited time to sound an alarm, and electricity failed quickly, plunging the ship into darkness. The Empress was gone in 14 minutes.

The survivors were picked up by the few lifeboats that had been launched, and were carried back and forth to the Storstad, which had stayed afloat. Captain Henry Kendall, who was thrown into the water as the ship rolled over, supervised the rescue efforts and likely saved many lives by organizing the lifeboats.

All together the Empress took 1,024 people with her. It remains the deadliest maritime disaster in Canadian history. In spite of this, the ship is mostly forgotten today. The St. Lawrence Seaway is a very busy channel. Hundreds of ships steam over the Empress every day, very few knowing of the tragedy beneath them.

The Salvation Army remembers. A large contingent of members (167) were lost on the ship, traveling to a conference in London. There is a monument to them at Mount Pleasant Cemetery, in Toronto.

The Empress of Ireland is in 130 feet of water, well within the range of scuba equipment, but the currents and poor visibility limit diving

Friday, May 28, 2010

Idiots on vacation

Dr. Grumpy: "How was your trip to South America?"

Mrs. Insensitive Tourist: "It was fine. But Chile was a dump. That earthquake was what, a month or two ago? You'd think they could have the place cleaned up and fixed by now."

Math fail

I'm doing an online medical research survey this morning. It began with this message:

"The study consists of 3 sections, each of which is 15 minutes in length. The study will therefore take 1 hour to complete."

Thursday, May 27, 2010

Dear BCBS insurance company,

Thank you for tying up my fax machine by sending me 27 consecutive copies of this page, with ABSOLUTELY NO OTHER RELEVANT INFORMATION WHATSOEVER!!!

(click to enlarge)




I'm just SO glad to know that my premiums, and our dwindling natural resources, are being put to such good use by you guys.

Thank you.

More priorities

Dr. Grumpy: "So how did this all start?"

Mrs. Trayler: "Well, on Sunday, I was doing some cleaning, and suddenly I couldn't move my right arm, and my daughter said my speech was slurred. So we went to Local Hospital."

Dr. Grumpy: "Hang on..." (logs into the Local Hospital records) "That's weird, the hospital has no record of you being treated there. Are you sure you went to this hospital?"

Mrs. Trayler: "Yeah, but I didn't stay. The lobby was full, and I was worried I'd have to wait, so I left."

Dr. Grumpy: "You left the hospital with a stroke?!!!"

Mrs. Trayler: "I had to. I mean, the NASCAR race was gonna start."

Department of Redundant Radiology Department

This report crossed my desk yesterday.

(click to enlarge)

Wednesday, May 26, 2010

Mary, you're fired. Again.

The scroll wheel on my mouse got stuck. So I turned it over and banged it hard several times on my desk to fix it (this works, sometimes).

From down the hall Mary yelled: "Hey! What's that noise?"

I said: "I'm beating my mouse back here."

Mary yelled back: "Whatever you want to call it. Next time close your office door."


It's behavior like this that gets Mary fired. I fire her an average of 5-6 times a day.

Tuesday night, 11:57 p.m.

My cell phone rings. I recognize the number as the OB floor. Crap! The neurological complications of pregnancy are, 90% of the time, benign. The other 10% are horrible. I hate getting calls from there.

Dr. Grumpy: "This is Dr. Grumpy."

Nurse Nightshift: "Yeah, I'm a nurse on the OB floor, and need to talk to you about a migraine patient."

Dr. Grumpy: "What's up?"

Nurse nightshift: "Which medication do you recommend for migraine prevention?"

Dr. Grumpy: "Um, well there's several, I... Look, if the patient is pregnant, I try not to use them. Is this one of my patients?"

Nurse Nightshift: "Uh, no. I mean, not yet."

Dr. Grumpy: "So it's a new consult? What's her name, and what room is she in?"

Nurse nightshift: "Actually... It's me. I have migraines, and um, I, uh, guess I need to make an appointment."

Dr. Grumpy: "So there isn't a hospital case I need to be aware of?"

Nurse Nightshift: "No. Not really. Can I make an appointment to see you?"

Dr. Grumpy: "Call Mary in the morning. Good night."

Tuesday, May 25, 2010

Comedy in the afternoon

I'm seeing a delightful, but VERY nervous older lady, who has a new cell phone. She's quite vocal about how she doesn't like it, but her son (Michael) worries about her, and so he bought her one.

Her phone rings about a minute into the appointment. She looks at it. "Oh, it's Michael. I don't want to talk to him."

I suggested ignoring it, and letting it go to voicemail. Or turning it off.

She said: "I don't know how. And I don't want him to worry."

So she answers the phone: "Um, uh, yes, hello, this is Doris, and I'm not home, so please leave a message. Beep."

She hung up. It took everything I had not to burst out laughing.

A few minutes later the phone rings again. She looks at me and says, "I'm sorry, but I really don't want him to think I'm ignoring him".

She answers it again "Hello, this is Doris, I'm not here, and can't take your call. Please, um, leave a message again. Beep."

This time we made it another 10 minutes before Michael called again. I offered to answer it for her, to tell him she was at the doctor, and shouldn't be disturbed. Of course, she didn't want him to know that, so fumbled with the phone again.

"Um, hello. This is Doris again, and I, uh, I mean, um, you have a wrong number."

I had to run to the bathroom so I wouldn't go to pieces in front of her.

He didn't call back after that.

The lost month

This post was inspired by a recent email with ABB.

Final exams are at the end of most school semesters, including medical school. So this post is dedicated to the medical students who are hunkered down right now in their study bunkers, preparing for the worst.

At the end of the second year of medical school is the USMLE-1 (United States Medical Licensing Boards, Part 1- the name is misleading, several countries use it). This covers every subject from the first 2 years of medical school: Anatomy, Biochemistry, Pathology, Pharmacology, Microbiology, Neuroanatomy, Physiology, Histology, and a few others. 2 years of learning, all in 1 awful test. When I took it the test consisted of 4 sessions spread out over 2 days. Each session had 200 questions, and 3 hours to answer them.

At my school, if you failed the test, you had to take it again. If you failed it twice, your medical career was over (though you still owed your student loans back).

It was the Summer of 1991.

I don't remember the specific dates. But basically, between the time med school ended for the Summer, and the dreaded test, was roughly 1 month. You had 30 days to re-study everything that had taken you 2 years to learn to that point. And pretty much your chances of a career in medicine depended on how you did.

So it was stressful. And, to this day, I still feel for all of you who are out there studying for it now. Any classmate, resident, or attending who tells you they weren't scared is lying.

Within hours of the semester ending, my class had gone into hiding.

I stopped shaving, to save time. My roommate, Enzyme, disconnected our TV, moved it across the room, and piled furniture in front of it.

My days consisted of me getting up at 7:30 and showering. I'd either stay at my apartment desk or walk over to campus to find an empty classroom to study in. I'd put in my trusty earplugs and the world around me ceased to exist.

Around noon I'd go back to my apartment for a PBJ, then go study again. At 5 I'd go back to my place for a sandwich, or ramen soup, or Rice-a-Roni. I'd sit out on my balcony and eat, for 15 minutes of relaxation. Or I'd read a book with dinner (Enzyme and I were both reading a single copy of "The Price of Admiralty" by John Keegan. It sat on our kitchen table for the month, and we'd have different eating times so we could share it). I never spent more than 30 minutes on a break. After dinner I'd go back to my desk, or campus. I'd study until around 3 a.m., then go home to sleep for a few hours.

I called my parents a few times. My daily outfit consisted of gym shorts (the short kind, from the 80's), T-shirt, sneakers, and the growing beard. Days blended together. There were no differences between weekends and weekdays. People I encountered were superfluous to my existence. I saw my classmates a few times, and we exchanged glassy-eyed nods as we passed.

I shaved a night or two before the test. I studied until around 11:30 p.m. on the eve of the test, re-reviewing a few last points.

It was weird, like I was living alone on another planet for 30 days. I have no idea what happened in the news that month. I was out-of-touch with everything but my books.

If there's one thing I came out of medical school with, it was this: The realization that there was absolutely, positively, no way you were EVER going to get everything read, studied, and reviewed that you needed to before the test.

And, somehow, when the test was over and the dust had settled, you'd done it. And you'd have no idea how. I still don't.

Good luck, everybody.

Monday, May 24, 2010

Patient quote of the day

"My headaches only happen when I'm sleeping, and are gone before I wake up. I don't remember them, either. So when I wake up, I don't know if I had one or not."

Shameless Plug

For those of you who haven't started reading Fizzy, you damn well should.

I have no idea who Fizzy is, and am not getting paid for this post. But she REALLY hits the nail on the head, cartoon after cartoon. I love it.

Non-medical people may not enjoy it as much as those of us who survived med school and residency, but it's still good.

Overheard at the hospital

I'm in one of those rooms with 2 beds, and a curtain between them, examining a patient. On the other side of the curtain a lady is ordering lunch from the hospital cafeteria dial-in service.


"I'll have the BLT sandwich. I want it with cheese, too. Oh, and multigrain bread. The cardiologist told me to eat healthy."

Sunday, May 23, 2010

Randomness from the road

Driving back and forth on call this weekend I've:

1. Been passed on the highway by a guy riding a motorcycle. Whose head protection consisted of a snorkeling mask- with snorkel attached, flapping in the wind.

2. Seen a guy go down the street, wearing only a baseball hat, mens bikini briefs, and rollerblades, pulled by 4 huge dogs. Like some sort of suburban musher.

3. Passed a pick-up truck with a table & 4 chairs in the back. 3 girls and a guy were sitting in the chairs, reading (with some difficulty in the wind) the newspaper, as if they were at a breakfast table and not going down the freeway.

Saturday, May 22, 2010

Did we take our Ritalin today?

Reading another doctor's note in a chart, found this:

"Patient has had multiple admissions for similar episodes, in 2002, 2003, 2004, 2006, and now. Blacks-out when standing-up. History of chest pain. Takes daily aspirin. Also had some sort of surgery in 1999, but doesn't know what. Recently started a new drug for his diabetes. Says the surgery might have been on his stomach. As an outpatient he sees Dr. Jones. Says his father had similar issues. Echocardiogram in 2008 showed normal ejection fraction. Retired accountant. Chest pain is gone now, but had some yesterday. All labs normal, but they show anemia and liver issues. Spent yesterday working in yard before the black-out. Felt clammy. Mother died of breast cancer in 1965. Sister living. Says he has an apppointment with a cardiologist as outpatient coming up. Moved here from Michigan. Had a head CT this morning, but hasn't been dictated. Currently is asymptomatic. Should probably consult neurology."

I agree with the last part. But the patient isn't the one who needs me.

On call

Just keep swimming.
Just keep swimming.
Just keep swimming.

Friday, May 21, 2010

My readers write

Reader Emily writes:


I was at my OB/GYN 's office this morning, in the waiting room, when I overheard the following conversation. I immediately thought of you.

Patient: "I think I have an appointment today but I'm not sure. You should probably look it up."

Receptionist: "Yes, ma'am, you have an appointment. Please sign in."

Patient: "What am I here for? Because I've been here before and I'm not sure why I'm back."

Receptionist: "I just have you down for a follow up."

Patient: "Ok. Thanks."


It's hard to believe these things happen in real life.

Yes, Emily, it is. And I'm glad to know it happens to other doctors, too. Thank you!

Music to be Grumpy by

For unknown reasons, several of you have written in wanting to know what I listen to. So here we go.

I have a pretty wide taste in music, with my iTunes having roughly 5000 songs on it, about 1/3 of which are classical pieces, and the rest are more contemporary. And I always play it on random shuffle, so any given day, while working at my desk, I hear a wide variety of stuff.

I have a lot of the same stuff you likely have, a mixture of top hits, "classic rock" (whatever that is anymore), other popular stuff, and some offbeat songs,. Rather then naming everything, I thought I'd list some of the lesser known stuff I listen to.

Here they are, with my impressions, in no particular order.

1. The Fabulous Poodles. This mostly forgotten group had only 1 hit in the U.S. ("Mirror Star", in the late 70's), but they were AWESOME. They did some of the most eclectic stuff ever, blending violins with modern rock instruments, and songs that span a remarkable gamut of styles and odd topics (suicide, dessert, anorexia, artificial body parts, vampires, etc.). A sampler collection called "His Masters Choice" is still out there on CD. It doesn't have all their good stuff on it, but it's still awesome.

2. Spinal Tap. Created for the excellent mid-80's movie of the same name, this group has endured, to the extent that some people now don't realize the whole thing started as a joke. Their collection of intentionally badly written lyrics and tasteless music somehow remains quite entertaining. I was listening to Spinal Tap long before I ever dreamed I'd be doing spinal taps for a living.

3. Shriekback. Okay, I only have 1 song by them ("Nemesis") but let's face it- how many other dance numbers feature the science word "parthenogenesis" in the chorus?

4. Sisters of Mercy. Again, I only have 1 song by them ("This Corrosion") but this dance number is remarkable for it's catchy beat, 10 minute length, and absolutely senseless collection of lyrics. The random phrases sound like something written by a guy with left-sided brain damage (which, for all I know, they were).

5. Tom Lehrer. American humor music is a triad of Tom Lehrer, Allan Sherman, and Weird Al Yankovic. All are good, but to me Lehrer is exceptional for his style of writing, and blending it with his advanced knowledge of mathematics and science. Allan Sherman is mostly forgotten today (he died in 1973), but his influence on all who've come since is unmistakable.

6. Maggie Estep. I may be the only person on Earth who bought her CD "No More Mr. Nice Girl", but it's awesome. More of a collection of poems read to music then true singing. But how can you NOT like a song featuring lyrics like "Fuck me and take out the garbage, feed the cat, and fuck me"? And her monologue "Bad Day at the Beauty Salon" is unforgettable.

7. Al Stewart. Remarkable stuff. Known primarily for his 1970's hit "Year of the Cat" and a few others, he remains an excellent songwriter and performer, who does fascinating work based on historical themes. His live album "Rhymes in Rooms" of just him and acoustic guitars, is one of my favorites. Ever.

8. Saturday Morning's Greatest Hits. What a great idea. Get a bunch of 1990's bands together, and have them re-record the theme songs from the 1970's cartoons I grew up listening to. Liz Phair's version of The Banana Splits" theme is awesome, and the album continues strong all the way through. Underdog. Hong-Kong Phooey. Speed Racer. Scooby Doo. Fat Albert. The Groovy Ghoulies, and many more. A related album of remade "Schoolhouse Rock" songs was okay, but not as good as the cartoon themes.

9. Gary Numan. Mostly remembered for his only U.S. hit "Cars", he actually had 3 interesting albums in the 1970's (Replicas, The Pleasure Principle, and Telekon) which were pioneering works in the use of synthesizers.

10. The Refreshments. Their album "Fizzy Fuzzy Big and Buzzy" is excellent. How many relationship songs have the chorus "I can't sleep, 'cause she snores like a chainsaw!"?

11. Northern Exposure. One of the few TV shows which I really, really enjoyed. The music CD contains an extended version of the theme song (which my mother calls "The Moose Dance") and a selection of songs played in the background during the show. They vary from Nat King Cole to Magazine 60 to Lynyrd Skynyrd.

On an unrelated note, I think this was one of the best TV series, ever. Did anyone else out there think it should have ended with the episode "The Quest", which featured Joel and Maggie looking for the "Jeweled City of the North"? To me, that one hit the right notes to end the show on, but instead they dragged it out for a few more episodes.

12. Sparks. Were these guys great, or what? Their greatest hits set contains their only popular song ("Cool Places"), a delightfully generic dance number called "Music That You Can Dance To", and even a song about sperm ("Tryouts for the Human Race").

13. The Dead Milkmen. These guys mastered the art of the quick song, with some of their stuff being less than a minute. The rambling musical monologue "Stewart" begins with the line "I like you, Stewart, you're not like the other people, here, at the trailer park" and goes on to discuss an accidental decapitation at an amusement park and paranoia about the government being in cahoots with homosexual martians to poison the soil.

14. Cast. These guys never really took off in the U.S., but I for one thought they were great. Their album "All Change" is a neat collection of songs that blends a 1960's retro sound with more modern stuff.

15. The Disneyland Soundtrack. Yeah, I know. I guess this is a hazard of going to the parks as a kid, and now having gone with my kids. It's simply a collection of music from the rides (yes, including the dreaded Small World) but is oddly entertaining. And certainly brings back memories. If you're driving when they hit the launching point in "California Screaming", it's hard to resist mashing the gas pedal and pretending you're on the ride.


Not an inclusive list, but for the inquiring minds who wanted to know, now you know.

Thursday, May 20, 2010

Another fine patient quote

"All foods make me sick, but only if I eat them on an empty stomach. So I usually take a snack before meals, so I don't get sick."

Attention well-meaning sister!

I know you're concerned about your sister, Kris. I mean, you don't have kids of your own, and live 1000 miles away, but you do talk to her on the phone regularly.

I guess you found out I treat her for headaches. I can't really talk to you directly, due to privacy issues, so please accept this as my answer:

Please DO NOT leave a message on my office voicemail saying that I need to work her up urgently for a brain tumor (you read about them in Reader's Digest) because she's been more forgetful and disorganized since having triplets 3 months ago.

It's not like you've been out here to visit in that time, either.

If you have even one kid someday, you'll understand. And when you do, multiply what it does to you by 3, then call me and Kris back to apologize.

Thank you.

History Fail

Mr. Hiztory: "I changed insurance because I'm afraid of Obama's plan."

Dr. Grumpy: "How long have have you had this policy?"

Mr. Hiztory: "Since 2006."

Dr. Grumpy: "He wasn't President in 2006."

Mr. Hiztory: "What does that have to do with it?"

Wednesday, May 19, 2010

Skool Nerse Time

This is Mrs. Grumpy.

I had a surprisingly quiet day in my office, with only a handful of visitors. So I decided to clean out one of the filing cabinets.

This is not, mind you, a cabinet I've ever put anything in. It's been in the corner of my office since I started this job. According to the school secretary it's been there as long as she can remember. And she's been here a LONG time. And the school dates back around 40 years.

So, the last time anyone actually looked in the cabinet remains a mystery. Basically, I was opening a time capsule.

A lot of it was dusty old records of kids who likely have grandkids by now. But in one drawer I found a pile of coloring books to give to kids, about child safety.

They were from 1972. And have likely been in the drawer since then.

So let's look at a few pages, shall we?

This page is the introduction. Isn't it amazing what you could get away with in 1972? These anglicized, stereotyped Native Americans likely wouldn't make it past a political correctness committee today.





Now this page is great. Yes, kids, that is a PHONE. When Dr. Grumpy and I were young you had to DIAL phone numbers (I know, I'm dating us here). NOT press buttons. NOT hit speed-dial. NOT say "call Buffy" to the phone. There was that BIG round thing on the front, and you had to dial in the digits ALL BY YOURSELF. So next time you hear someone say "dial a number" or "dial tone", you know where the expression came from. And yes, clowns really were that creepy back then. And, for the most part, still are.





This next page, however, is my favorite. In 1972 it was apparently considered normal, and safe, to leave GUNS AND AMMO lying unattended around the house, provided your kids had been told not to touch them. After all, if you tell kids not to do something, they ALWAYS listen and know better then to actually do it. Right?






I hope you've enjoyed this trip down memory lane. If you have young kids, and you're not at home right now, please dial them up to remind them not to play with the guns or let clowns in the house (if clowns are already in the house, then it's better that your kids have access to guns).

Yo ho and a bottle o' pee!

Dr. Pissy or I occasionally order a urine test. So we have a patient bathroom with a bunch of urine sample cups & lids, and a Sharpie ink marker. Patients are told to write their name on a cup, pee in it, and put it in our lab.

So yesterday afternoon a lady walked out of the bathroom. Annie and I were talking in the hall, and she flagged us down.

"Um, excuse me, I have to give a urine specimen, and want to know how much you need. There are, like, 20 cups on the counter in there, and I don't think I can fill them all up."

Tuesday, May 18, 2010

What the hell?

Dr. Grumpy: "Any illnesses run in your family?"

Mr. Fallz: "Yes. My brother is 3 years older than me, and my sister is 7 years older than me. So I guess both my siblings are older than me. My parents are also older than me."

Not a good sign

It's never a good sign (at least in a neurology practice) when this shows up on a new patient form:

(click to enlarge)


Monday, May 17, 2010

Attention Drug Reps!

When you tell me that your product causes less constipation than your competitor, I'm happy to look at your colorful brochure and nod.

I do not need any kind of personal endorsement.

Specifically, I really don't care to hear about how YOU got horrible constipation from the other drug, and all the methods you had to use to finally be able to relieve yourself.

Especially when you brought us a lunch of tuna sandwiches on brown bread.

Although I do think it's funny that your company's health insurance won't cover its own drugs.

Have a nice day.

Society pages

Harder to get invited to than a Presidential Inaugural Ball...

Fancier than an upper-crust party on the Queen Mary 2...

Wilder than a post-Oscar Hollywood bash...

Yes, this past Saturday was the annual Wingnut Elementary School Daddy-Daughter Dance.

As usual, the attendees were an A-list from Wingnut School grades 1-3, accompanied by their (considerably older) dates. This annual event, which is often mistaken for an FLDS mass-wedding ceremony, is the social event of the season for the young ladies.

The evening begins for most at an elaborate banquet, with swanky restaurants chosen by the gals. Bistros are selected for atmosphere, food, and (most importantly) the current month's Happy Meal offerings.

Marie Grumpy this year chose the elegance of a Denny's, and, when handed a Kid's Menu, glared at the server with obvious disdain and asked for "the grown up menu, the one with salmon on it." Rumor has it that her escort had grilled cheese.

Dresses in all colors of the rainbow were popular among the debutantes. Marie Grumpy was resplendent in a black dress, brown socks, and knee-high leather boots that she found in the costume closet (and was quite insistent on wearing). She completed her outfit with a shark-tooth necklace she'd purchased at SeaWorld last Summer.

Upon arrival at the event guests were greeted by a sumptuous hors d'oeuvre buffet of cookies and juice boxes. They were then ushered into the dance hall, which had been cleverly decorated to look like a grade school gym, with basketball hoops hanging from the ceiling and bleachers along the walls.

And so the festivities began. The floor was covered with balloons, whose popping (as they were stomped upon) added to the loud music and disco light display. One participant described the delightful spectacle as "migraine-inducing". It also led several of the young ladies to break decorum in a light-hearted balloon fight, which escalated to injuries serious enough to require a small band-aid to cover a boo-boo in one victim.

One unidentified father (but we all know who you are, Mike) graced the scene by wearing a HOT PINK TUXEDO to the event. This outfit certainly made him stand out from the rest of the crowd, especially when he danced on top of a table during "YMCA". His young escort was last seen by the ladies room, with a paper bag over her head.

Another injury occurred when a father was assaulted near the cookie table. He'd apparently never seen the Animal Planet show about "never get between a mother bear and her cubs", and didn't realize that it was even more dangerous to get between Marie Grumpy and the chocolate chip cookies.

One father spotted a neurologist, and cornered him to ask about groin pain. He had to yell to be heard over the music, and learned (the hard way) that if the music stops, and you keep yelling, then EVERYONE can hear about your medical concerns.

Another lovely princess had to leave early, after she vomited all over the dance floor. Her escort brazenly told the crowd, "she's been barfing all day, but I figured she'd stop after we got here." A local neurologist who witnessed the event commented that "although it's really not my field, generally a handful of cookies and a box of juice isn't a great treatment for projectile vomiting." We can only hope other parents will heed that advice next year.

The after-party was held at Local Ice Cream Parlor, where several interesting combinations were tried. Marie Grumpy had cotton-candy ice cream with Kit-Kats, while a young friend of hers had chocolate fudge with Gummi bears.

All are looking forward to next years ball, except for the guy in a pink tuxedo, whose man-card has been revoked.

Sunday, May 16, 2010

The men on the flying trapeze

I felt like doing a history post today, so indulge me.


One of the most fascinating side stories in the history of aviation started in the 1920's, with rigid airships (similar to today's blimps, but with metal frames). The U.S. Navy built several giant helium ships for military purposes. They had many advantages over the airplanes of the time, primarily in their range and endurance.

The nature of airships made them excellent for reconnaissance, but they needed to cover large areas in several directions at once. At the same time, they were difficult to defend. The slow, lumbering, giants could be shot down easily by enemy aircraft.

So to solve both these problems, a remarkable idea came about, and 2 were actually built: flying aircraft carriers, the U.S.S. Akron and U.S.S. Macon.





These were huge ships. 3 times as long as a 747 is today. With a crew of 80-90 men, and all their accommodations: Sleeping quarters. Galleys. Mess halls. Offices. Laundry rooms. Machine shops. Supply storage areas. Bathrooms. All in a gigantic flying home that could travel 12,000 miles without refueling.

The technological challenges of such an idea were hard to meet, but were gradually worked out. A small fighter plane, called the Sparrowhawk, was specially designed. Each ship was given an internal hanger and maintenance facilities, and carried 4-5 Sparrowhawks.

Special training was obviously needed for the unusual launch and landing procedures, both of which were gut-wrenching events.

To launch, a Sparrowhawk's engine was started, and the plane was lowered out of the hanger- then dropped. Gravity and the engine did the rest.





To "land" was even trickier. Each plane had a large hook on top, and would fly underneath the huge airship to a metal bar, then try to catch onto it. Once that was done, the whole assembly was pulled back into the hanger, the plane was disconnected, and the bar was lowered back out again for the next plane.







The handful of pilots who mastered this difficult feat were an elite group, and even received a special squadron insignia: "The Men on the Flying Trapeze".







To prove the usefulness of the ships, the captain of the Macon (Herbert Wiley) was determined to do what was considered impossible in 1934 - to find a single ship somewhere in the Pacific ocean. He carried out an unauthorized mission to find a specific target: The President of the United States.

President Franklin Roosevelt was on board the U.S.S. Houston, en route to Hawaii. A needle in a haystack, somewhere in the 3000 miles between North America and Hawaii.

And Wiley did it. The Macon found the Houston 1500 miles at sea. Look-outs on the Houston were shocked to find themselves pursued by airplanes, since that distance was far beyond what any land-based plane at the time could do. Knowing that the President enjoyed reading the daily paper, Wiley had his pilots drop the most recent San Francisco newspapers onto the Houston for him.

Wiley faced a court martial because his mission had been unauthorized. President Roosevelt was so impressed by the feat that he interceded on his behalf.

The Macon and Akron carried out a number of successful reconnaissance drills in the early 1930's, but the fragile nature of lighter-than-air vehicles worked against them. Both were lost in violent storms over water, and future development of the idea was abandoned.

The Akron sank off the Atlantic coast, the Macon off the Pacific. Both wrecks have been found and explored, including their lost Sparrowhawks.

Although now obsolete, the amazing idea hasn't been forgotten. The airship in the 2009 movie "Up" had several small fighter planes, which were based on the design of the Sparrowhawk.

Saturday, May 15, 2010

Friday night, 10:57 p.m.

"Hello, I'm calling for the MRI-scheduling lady for Dr. Grumpy. You left me a message that my MRI is on May 21, and that is, like, my birthday, and I'm real claustrophobic and need sedation for my MRI so I don't, like, freak-out or shit like that, so I can't have it on my birthday because I always spend my birthday driving around to my friends' places and smoking pot with them, so I can't be sedated on that day because then the drugs to help me have the MRI would make me too sleepy to drive, and that's not safe."

Friday, May 14, 2010

Must need a helluva big pill bottle

Dr. Grumpy: "How much Inderal are you on now?"

Mr. Hedayk: "80 megatons a day."

Dr. Grumpy: "You mean milligrams."

Mr. Hedayk: "Whatever."

Dear Dr. Worthless,

Thank you for your note on my migraine patient.

I've tried several medications for Mrs. Hedhurtz, including Fukitol, Painbegone, Nomigraine, Acefalgia, Gonehert, and Nopayn, all without success.

I've done MRI's, MRA's, and a spinal tap on her. I sent her to an ophthalmologist.

I was frustrated. She was more frustrated. I wasn't having a lot of success helping her. And she seems like a nice lady.

So, since you advertise yourself as a neurologist who specializes in treating difficult headaches, and cite your 2 years of headache subspecialty fellowship training, I decided to refer her to you. You opened up shop near me last month, so I thought I'd give you a chance to earn my referral business. Your marketing person dropped off some cards here 2 weeks ago.

And yesterday I got your faxed note about her.

At the beginning of your note it says that "I've reviewed Dr. Grumpee's notes and tests in detail." That was your second lie (your first lie is in calling yourself a headache specialist, or even a doctor). I also loved the fact that you spelled my name wrong.

Your note ends with the following, which I've paraphrased.

"Impression: Mrs. Hedhurtz suffers from chronic headaches. She's previously failed trials of Fukitol, Painbegone, Nomigraine, Acefalgia, Gonehert, and Nopayn. I suggest she be referred to an ophthalmologist. A spinal tap should also be considered.

For future treatment, I suggest she be started on a medication that she hasn't previously tried before. I've referred her back to Dr. Grumpee's care to follow my recommendations.

Yours truly,

I. M. Worthless, M.D."


Thank you SO fucking much for your helpful advice. I'd normally say "thanks for nothing", but what you've done doesn't even amount to that much.

As my late grandfather would have said, "this is the second time I've sent you a patient. First and last."

Sincerely,

Ibee Grumpy, M.D.

Thursday, May 13, 2010

Compromising and Improvising

Mrs. Grumpy is out of town at a nurse's meeting for 2 days. So I'm trapped with the wild bunch.


Dr. Grumpy: "Hey, what do you guys want for dinner?"

Craig: "Tacos!"

Frank: "Hot dogs!"

Marie: "Don't care."

Frank: "We had tacos last week! He always gets what he wants!"

Craig: "You had a hot dog for lunch yesterday."

Frank: "You idiot!"

Craig: "You're stupider than Snowball!"

(scuffle)

Dr. Grumpy: "STOP THAT!!!"

(silence)

Dr. Grumpy: "Let me look in the fridge."

Hmm. We have some hot dogs, leftover taco meat from last week, shredded cheese. No buns, or bread. How can she leave us without bread?!!! Now what do I do...

Dr. Grumpy: "Okay! Instead of hot dogs or tacos... We're having Taco Dogs!"

(Put together on the spur of the moment from leftovers. A taco shell, with a hot dog, taco meat, and cheese. They were surprisingly popular, albeit unhealthy).

Some days I can't win

Dr. Grumpy: "So, at your last visit I gave you Imitrex for your migraines. How did it work?"

Ms. Aura: "Oh, it was wonderful. I had a migraine last week, and I took it, and within an hour the headache was completely gone!" (suddenly breaks into tears)

Dr. Grumpy: "What's wrong?"

Ms. Aura (sobbing uncontrollably) "I just feel so guilty for taking it!"

Attention staff!

I made myself some tea this morning.

If I catch the person who filled the little lemon juice thing with Tabasco sauce, your ass is FIRED!

Wednesday, May 12, 2010

Wednesday Afternoon

(Lady with bad hair comes in, stands at front counter)

Mary: "Can I help you?''

Mrs. Badhair: "What suite is this?"

Mary: "405."

Mrs. Badhair: "Where is 507?"

Mary: "Upstairs, on the 5th floor."

Mrs. Badhair: "Does this building have 9 floors?"

Mary: "Um, no. Just 6 floors."

Mrs. Badhair: "That's weird. Because the parking garage across the street only has 4 floors."

Mary: "Um... Yes it does. But this office building has 6 floors."

Mrs. Badhair: "There are cars in the parking garage, too."

Mary: "It's a parking garage."

Mrs. Badhair: "Well, yeah!"

And she walked out.

Confused, possibly hallucinating. Not incontinent yet.

Dr. Grumpy: "I think your condition will either get better, worse, or stay the same."

Mr. Patient: "Doc, that sounded really stupid."

Dr. Grumpy: "Um, yes, it did. Let me rephrase that."

Kate's Desk

This story is absolutely true, as hard as it may be to believe. It happened roughly 10 years ago, when I had a secretary named Kate. I was reminded of it by a post a while back on Fast Food Pharmacy.


Kate: "Dr. Grumpy's office, this is Kate."

Mr. Collie: "Yeah, does Dr. Grumpy treat seizures?"

Kate: "Yes, he does."

Mr. Collie: "Then I'd like to make an appointment for my son."

Kate: "Okay, what's his insurance?"

Mr. Collie: "He doesn't have any, we'll pay cash."

Kate: "Okay, what's his name?"

Mr. Collie: "Wind. I guess, Wind Collie"

Kate: "Okay, and how old is Wind?"

Mr. Collie: "He's 7."

Kate: "Oh, I'm sorry, Dr. Grumpy doesn't see anyone under 18."

Mr. Collie: "Well it's, uh, more like he's an adult, because he's 49 in human years."

Kate: "WHAT! You mean he's a dog?"

Mr. Collie: "No. Ummm... Well, sort of, I mean... Yes."

Kate: "You'll need to take him to a vet, sir."

Mr. Collie: "I don't like our vet. Can't you guys just see him?"

Kate: "No, sir. We only treat people."

Mr. Collie: "That's ridiculous." (hangs up)


Kate quit 3 days later.

Tuesday, May 11, 2010

Department of Redundancy Department

"I'm being treated for depression, because it's really depressing to be depressed."

Calendar WTF?

Dr. Grumpy: "How often do you miss a medication dose?"

Mr. Gregorian: "Um... Once a month. So in a given year, it would vary depending on the months in a year... so I'd say I miss 8-14 doses per year, depending on that year's calender".

Come on, I hadn't even had a Diet Coke yet

While reviewing notes on patients coming in today, I discovered the following in a hospital discharge summary:

"The patient was seen by Dr. Grumpy. He was confused, incontinent, and hallucinating at the time."

Monday, May 10, 2010

So you came here instead

Dr. Grumpy: "What can I do for you, sir?"

Mr. Orchid: "My balls hurt. And my di..., um, penis, does, too."

Dr. Grumpy: "Have you seen a urologist?"

Mr. Orchid: "No. My internist told me to, but I was too embarrassed to call one. So I thought I'd start here."

Once upon a time...

Okay, everybody, let's take the Way-Back Machine to the early 1990's, when 4th year medical student Dr. Grumpy is interviewing for residency.


After medical school, young docklings go off to residency in our chosen fields.

But before we get into residency (through a mysterious process called "the match") we go off on interviews. Just like any other job.

I did my share of these interviews, traveling to 7 neurology programs in the early 90's to peddle my wares. These aren't quite as stressful as medical school interviews (for those you're begging them to take you, while for residency they need you & you need them, so both sides are trying in impress each other).

And this is the story of my least impressive interview:

I'd flown into the city the night before, and spent a relaxing night at a Motel 6.

The interview instructions said I was to begin by attending the Shitzenfuk Hospital Neurology conference at 7:30 a.m. This was several miles from the residency program's main hospital. And they actually told me to "ask around when you get there, and find a doctor willing to drive you back to our offices after the meeting".

So I took a cab from my motel to the hospital, and found the auditorium. Here I am, in a strange city, dragging my overnight bag around, with a bunch of docs who I don't know and who don't know me, and I'm walking around trying to bum a ride. Finally, after several looked at me like I was a sexual predator, one finally said. "Okay, I'm heading that way. I guess I can give you a ride."

Guess what? He turned out to be the freakin' chairman of the program I was interviewing at! He'd signed the letter telling me to bum a ride. You'd think he could have offered initially, since he knew I'd be there, but no.

So we walk out to his car. Mind you, I'm not a car person. I don't expect doctors to be driving expensive things (my own car is a 2000 Nissan), but was still shocked by Dr. Chairman's mean set of wheels.

It was an early 70's Japanese something. Missing the right front fender. The trunk was half open, held down by a bungee cord threaded through a rust-hole.

I opened the passenger door. And a pile of empty soda cans, newspapers, fast food containers, orange peels, and heaven knows what else, fell out. Dr. Chairman said "sorry, let me clear that off" and began chucking the pile of garbage into the back seat (which was already covered with trash).

And off we went. It was December, and cold. My window was open. I tried rolling it up, but he said, "there's no window there, it broke years ago." The heat didn't work, either. So I was shivering away, with my overnight bag on my lap (no space for it anywhere else in the car). I hoped his driving skills were better than his car-care talents, because my seatbelt didn't work.

So we got to Neurology HQ. Where Ms. Bitchy at the desk (Dr. Chairman abandoned me as soon as we walked in) claimed I hadn't been invited for an interview, even when I showed her my letter. Eventually she realized she was looking at the previous week's schedule, and blamed me for having handed her the wrong schedule (which she'd actually pulled out of her own damn desk).

Then it was time for my tour of the esteemed facilities. Ms. Bitchy directed me down a hall, and told me someone would meet me there.

Fortunately, one did. It was a nice guy named Pete, who (allegedly) was the chief resident. We talked for a minute in the middle of the building's lobby, which had white pillars everywhere, and halls leading in different directions.

After giving me a brief summary of the areas we'd be going to, Pete said, "It's a beautiful hospital. Follow me." He then turned around and walked straight into a pillar, breaking his glasses.

I helped Pete up, while some other guys in white coats ran over to try and stop the blood now pouring out of his nose.

As they led him away, Pete told me to wait in the lobby. A few minutes later Ms. Bitchy showed up, leading a girl in scrubs who'd apparently been on call the night before, and looked (understandably) less then enthusiastic about showing me around. It was a pretty quick tour.

Afterwards I had an interview with a doctor, who used most of our interview time to return patient calls. He also called Mastercard to argue about some charges, which he blamed on his ex-wife.

Then it was (per the schedule) lunch with the residents. None showed up. It was me and 3 attending physicians. Ms. Bitchy, the secretary-from-hell, had only ordered 3 lunches. She gave one to each of the doctors, and told me where I could find the hospital cafeteria.

I just went hungry, and spoke to the doctors. One of them told me he thought the newfangled MRA technology was a passing fad.

Then it was another interview. This time with Dr. Chairman of the crappy car. Who'd inexplicably left for the day. No one knew where he'd gone, or why.

Thus ended the interview. Ms. Bitchy told me she'd arrange a ride for me back to the airport, but given her remarkable organizational skills displayed thus far, I declined. She wouldn't let me use the phone on her desk, so I found a pay phone and called a cab.

I ranked them last. I have no idea where they ranked me. And no, I didn't go there.

Sunday, May 9, 2010

Mother's day is over! Get back to work!

From May, 1955.

Put down the club, honey, I'm just joking. Really. Now put it down.

(click to enlarge)

Mother's Day at the Grumpy House

Mrs. Grumpy: "Aw, Frank! You made me a friendship bracelet! How sweet!"

Frank: "I didn't make it. I found it in Mrs. Leverton's garbage can."


AND


Marie wrote a card, with this line: "Dear Mom, I apreshat all of the things you do. Like when I don't get to the bathroom in time. The next thing I apreshat is that you make dinner good."

Saturday, May 8, 2010

Doc, can we stop for some water?

This morning I was doing an internet survey on Multiple Sclerosis. If featured this question:


"Which of the following in-office gait evaluations do you routinely do on Multiple Sclerosis patients during their appointments:

A. Timed 25 foot walk.

B. Timed 10 meter walk.

C. Timed 500 meter walk."


(If any doctor out there has an office hallway long enough (or even the time!) to do C, you should probably consider downsizing a bit).

Why I'm a neurologist, Reason #27

Because if someone ever decides to make a statue of my greatness, I REALLY don't want it to look like this:




Thank you to my reader Mark, for sending this in.

Friday, May 7, 2010

Skool Nerse Time

This is Mrs. Grumpy.


Kid: "Nurse, I feel dizzy."

Nurse Grumpy: "When did this start?"

Kid: "A minute ago on the playground. It's better now. I'm not dizzy, 'cause it's gone. But I feel like I might get dizzy again, at any second."

Nurse Grumpy: "What were you doing when this started?"

Kid: "Me and Jamie were spinning around, to make ourselves dizzy."

Hmm... Do you think it's your allergies?

"My headaches are worse, but it's because of my allergies. I have terrible allergies. This time of year I have allergies. I'm allergic to everything right now. It's my allergies, making my headaches worse. I'm pretty sure it's my allergies. Whenever my headaches get worse, it's always from my allergies."

Thursday, May 6, 2010

Skool Nerse Time

This is Mrs. Grumpy.


Dear teachers at my school,

I know that the school year is dwindling down, and many of you (not to mention the students) are frothing at the bit to get out. Tempers and sanity tend to get frayed this time of year.

Now, I know kids do a lot of stupid things. My mentally damaged husband actually spent an hour in his high school nurse's office for swallowing a chunk of dry ice (and still hasn't stopped belching, by the way).

There are many good reasons to send a kid to my office. Recently, though, the number of questionable reasons to be sending them has increased. This usually happens this time of year.

So, to be helpful, I'm putting up a list of NOT ACCEPTABLE reasons to send a child to the school nurse. All of these are things I've seen in the last 2 weeks.

1. "Left his lunch box on the school bus."

2. Any student who comes to my office (for the 3rd time in 5 hours, too) with a note that says "Reason for nurse referral: I'm sick of his crap. Talk to him about it."

3. To get a knot out of a shoelace.

4. To show them how to tie shoes.

5. To tell them to tell their mother that she should quit smoking.

6. "He says his butt itches."

7. "Says she's tired of being at school". REALLY! THAT'S WHAT THE TEACHER WROTE!

8. Chews gum.

9. Chews gum too loudly.

10. Swallowed gum.

11. Ate lunch before lunch hour.

12. "Left money at home". I'm a nurse, okay? Not a bank!


So, please limit your referrals to my office to kids who legitimately need health care, and we'll make it through the next few weeks together. Thank you.

Priorities

Dr. Grumpy: "Why did you stop your Plavix?"

Mr. Choochoo: "Quite frankly, doc, it's too expensive. I can't afford to pay for the pills and still meet my other living expenses."

Dr. Grumpy: "I understand that, but I'm concerned that without it you'll have another stroke."

Mr. Choochoo: "After insurance, Plavix is still $75 a month. Model trains aren't cheap."

Dr. Grumpy: "Model... trains...?"

Mr. Choochoo: "Yeah, I'm building a whole new track loop onto the set in my garage, and the trains and miniatures cost a lot." (whips out iPhone) "Here's some pictures of how it looks so far..."



15% off white scrubs with code "white_lyt"

Attention Hospital Staff!

A 95 year-old man with Alzheimer's disease, a crappy heart, gangrene in both feet, and a DNR order, who's been goofy since you began giving him Morphine 3 FREAKING DAYS AGO, is NEVER EVER EVER, under ANY circumstances, a STAT neurology consult for confusion NO MATTER HOW MUCH MONEY HIS FAMILY HAS GIVEN THE HOSPITAL FOUNDATION!!!!!

Wednesday, May 5, 2010

Helping the handicapped

I'd like to thank my reader AggEd for submitting these pictures she took of a well-marked handicapped parking space at her local mall.









Annie's Desk, May 5, 2010

Annie: "Dr. Grumpy's office, this is Annie."

Mr. Derm: "Yeah, Dr. Grumpy prescribed Lamictal for me last week, and now I've got a bad rash all over."

Annie: "Yeah, it can do that... Let me go ask him." (puts patient on hold, grabs me in hallway for advice, goes back to phone). "Yeah, he says you need to stop it."

Mr. Derm: "I haven't started it yet. I forgot to pick it up at the pharmacy."

Does he take your insurance?

Dr. Grumpy: "Have you ever seen a doctor for these symptoms?"

Mr. Aura: "Sort of, I talked to a guy about them."

Dr. Grumpy: "Is he a doctor?"

Mr. Aura: "No, he fixes cars."

Tuesday, May 4, 2010

Medical Research

Okay, I've made fun of medical research studies here and there for bizarre, useless, redundant findings, and redundant findings.

But a study published yesterday in the respected journal Pediatrics has stunned even me.

This study found that (shocker!) overweight kids are ALMOST TWICE AS LIKELY to get teased/bullied than kids who are of average weight.

Really. They did a study to find this out.

I'm sure someone out there is going to claim I'm supporting bullying. Or making fun of the overweight. But my ONLY point here is this: does this conclusion actually surprise anyone? Was this research necessary?

Disclaimer: I was NOT a bully. I was the bully-ee. So don't look at me as someone defending the playground thug. I hated them.

These researchers, using somebody's money, actually studied 821 kids in 3 elementary school grades in multiple schools across the U.S. It didn't say how long this groundbreaking research took. I can only assume that we've now learned everything there is to possibly learn in pediatrics, and so research is expanding into this sort of stuff.

Let's face it. ANYONE who grew up in the American school system (and likely any school system on Earth, after all, Augustus Gloop was German), could have told them this. Any KID in school today could have told them this. Any PERSON who watches a playground for 10 minutes could have told them this (although more likely would be arrested for being a stranger watching a playground and taking notes).

But, to prove my hypotheses, I did my own research, using 3 renowned scientists:

Marie Grumpy is known for her veterinary research in improving the eyesight of dogs.

Craig Grumpy is known for techniques to convert pharmaceutical models into aquatic habitats.

Frank Grumpy, at an early age, did research into how many cardboard boxes full of adhesive band-aids can be flushed down a toilet at once (his submission to American Plunger Journal was rejected because he didn't know the alphabet at the time).

So I showed each subject 2 pictures, which I found on Google images. One showed a thin kid, and the other a not-so-thin kid. Each of my 3 associates was asked which kid Jake Rottweiler (their school bully) was more likely to pick on.

All 3, in separate questioning, and with no access to their colleagues' answers, picked the not-so-thin kid.

My project took all of 15 minutes, and cost me a $3.49 half-gallon of Cookie-Dough-Explosion ice cream (to pay my research subjects for their time).

Take that, Pediatric journal writers.

New word of the day

Dr. Grumpy: "Did your mother have migraines?"

Mrs. Neologism: "No, my family doesn't have any hereditarialistic diseases."

Biting my tongue

"This all started at the local golf tournament. I'd forgotten my own set of clubs, and so when we got to the tee I had to use my husband's, and was angry that I'd left mine at home. Anyway, with everyone watching, I yanked out my husband's club and began waving it around, just as a joke. I think I hurt my hand because of the way I was holding it."

Convalescense

Yesterday, you may have noticed my posts ended early. This is because Dr. Grumpy was temporarily rendered into a barfing idiot by the evil pukingfeverachingholyfuckIfeellikeshit virus.

It started in mid-morning. I tried to stay at work, but just couldn't.

I had Mary reschedule the patients (which I HATE doing). I could barely think, or stay out of the bathroom (if you're part of the night staff that cleans my office, I'm really sorry I did that in my trash can). I had to get home.

Fortunately I live near my office. The kids were in school. So I thought I'd be able to rest and be sick alone for the day.

Fat chance.

I opened the door and...


Snowball: The people! The Master is home! He's home early! Ohboyohboyohboy!!!

Cooper: I am so happy! The Master! I must bring him something to welcome him! Here are Craig's underwear with skidmarks for you, Master! I found them in the laundry pile!

Blackdog: Stay away from him, you bozos. He smells bad.

Cooper: No! It's him! We must bounce in front of him to have him pet us! He loves it!

Snowball: Ohboyohboyohboy!


I grabbed a big tupperware bowl and collapsed onto my bed...


Blackdog: I'm going to stay in the hall. He doesn't look right.

Snowball: He's lying down! He's wants to play! He wants me to jump on the bed and bounce on his stomach!

Cooper: Play! Play! Play!

Snowball: Look! He's filling the plastic bowl up with semi-digested food!

Cooper: Wow! Just for us! I love the Master!

Blackdog: I wouldn't touch that. It smells like Diet Coke and Corn Flakes.


I doze off...


Cooper: The Master doesn't look happy.

Blackdog: No shit. Leave him alone.

Snowball: No! We need to cheer him up!

Cooper: I know! We must bring him gifts to make him happy! Come help me knock over the laundry basket full of wonderful-smelling sweaty clothes!

Snowball: Great idea!

Cooper: See! Look at them all over the floor! He will be so happy! Now let's bring all of them and put them next to the bed for him to see!

Snowball: Hey! A tennis ball! I'll bring that, too!

Cooper: Yes! I'll move the clothes and you bring more tennis balls!

Blackdog: Dipshits.


I woke up, desperately needing to barf. I got up to run to the bathroom...


Cooper: The Master is awake! He is jumping out of bed!

Snowball: Yes. He is running... and tripped over the big pile of smelly clothes!

Cooper: Look! He's lying on the floor now! He must want to play!

Blackdog: I don't think so.

Snowball: I'm going to jump on his back! Ohboyohboyohboy!

Cooper: He's running to the bathroom again! I'll jump in front of him to play!


Exhausted, I somehow made it back to the bed and fell asleep again...


Blackdog: Alert! There is a man at the mailbox! We must let the Master know!

Cooper: Yes! Make noise! Everyone! We must warn him!

Snowball: Yes! Now! Lots of loud noise! I'll jump up on the bed next to him to bark, to make sure he hears me!


I'm SO glad to feel better, so I can be back at the office today. It's comparatively relaxing.

Monday, May 3, 2010

Things that make me grumpy

Ms. Crappystaff: "Dr. Imed's office."

Dr. Grumpy: "Hi, it's Dr. Grumpy. You guys referred Mrs. Brain to me for an abnormal MRI, and I don't have the report. She's here now. Can you please fax that over, ASAP?"

Ms. Crappystaff: "Hang on... Sorry, the doctor just went into a room with a patient, and doesn't like to be disturbed. I can have him call you back later."

Dr. Grumpy: "I don't need to talk to him. I just want you to fax over the MRI report."

Ms. Crappystaff: "I'm not comfortable doing that. I don't know what the report means."

Dr. Grumpy: "I'm not asking you to know what it means. All you have to do is fax it to me."

Ms. Crappystaff: "Don't patronize me. I don't even know who you are."

Dr. Grumpy: "I'm Dr. Grumpy. You faxed over an insurance authorization on this patient an hour ago. I just need the MRI report, so I know what to tell her."

Ms. Crappystaff: "I told you, I'll have Dr. Imed call you to discuss this."

Dr. Grumpy: "The patient is here now. I just need the MRI report. Please fax it over. It's why you guys sent her to me."

Ms. Crappystaff: "You obviously don't understand the importance of patient privacy."

And she hung up.

Continuing Medical Education

Doctors, to keep our certifications, are required to do 20-30 hours of continuing education per year. Some docs go to conferences. Some do them online. Others do them in writing.

The format is the same. There's always an article, followed by a quiz you have to pass (to prove you really read it), then an evaluation form with some pointless questions (Did you like this CME? How will you change your practice because of it? Was it free of commercial bias? What other topics would you like to see CME on? Are you bored shitless yet?).

Anyway, yesterday I was doing a CME on new MRI techniques in Multiple Sclerosis. While filling out the evaluation form I came across this question.

(click to enlarge)





It is entirely unrelated to the CME topic. I can only assume it was put in there to see if I was still paying attention (yes, I was. And I do wash my hands at least twice a week).

Sunday, May 2, 2010

Sounds good, Frank

Frank had to write a report about dogs for school, and asked me to proofread it for him. I discovered this:

"Some dogs have very good eyesight. Because of this, they can hear in the dark."

Sunday reading

Okay, while relaxing outside and catching up on my journal reading today, I learned the following ground-breaking medical news:

1. Sleep deprivation can impair your thinking, while getting some rest can improve things again (Neurology Reviews, April, 2010).

2. Patients who get two blood thinning drugs have a higher risk of bleeding than patients who get only one (Archives of Neurology, March 8, 2010).

3. People who smoke have an increased risk of stroke and TIA (paper presented at the 2010 International Stroke Conference).

Sunday morning, 7:57 a.m.

Dr. Grumpy: "Dr. Grumpy, returning a page."

Mr. Husband: "Yeah, you see my wife for Alzheimer's disease, and she had a seizure 2 weeks ago."

Dr. Grumpy: "Uh huh."

Mr. Husband: "Well, ya know, I was just thinking, she was maybe just a bit more alert for a few days after the seizure, not a lot, but maybe a little. Can I bring her in to your office and you can make her have another one?"

Saturday, May 1, 2010

Scintillating conversation

Tonight Mrs. Grumpy and I were sitting on a bench at a local park, listening to a band. A group of teenagers went by, and we heard this discussion:


Dude A: "So like, you go to North High?"

Dude B: "Yeah."

Dude A: "I go to Central. What's it like at North?"

Dude B: "We have, like, students and teachers and stuff. Classes, too."

Dude A: "That's cool."

Need nutrition? Got fungus? No problem!

I'd like to thank my reader Boris for submitting this oddity.


 
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