Friday, November 7, 2014

Question of the week

"Doctor, how do I know if I'm having a headache?"

Thursday, November 6, 2014

I'm just here for the knives

Seen in a surgeon's note:



Thank you, Glen!

Wednesday, November 5, 2014

November, 1932

This week in 1932, a war was fought... One that would see the Australian military suffer what may be the most bizarre defeat in the history of armed conflict.


In the midst of the worldwide depression, Australia's Summer wheat crops were attacked by a marauding hoard of roughly 20,000 emus. The birds found it was easier to eat grain off cultivated rows than forage for it, and settled in.


"Our ancestors were Tyrannosaurs. Who's going to stop us?"

Emus are not small objects. After its cousin, the ostrich, it's the second biggest bird on Earth. They can't fly, but can kick viciously and run at over 30 mph. Their claws easily shred wire fences, and they're big enough to jump over or knock down most wooden ones. They can grow to a height of 6'6" and weigh up to 125 lbs.

In summary, they're not going to be threatened by a scarecrow. Or much else.

The farmers appealed to the government, and the Minister of Defence, Sir George Pearce, felt this was an excellent way of both assisting the farmers and getting his troops some target practice. Machine guns had helped break the Western Front stalemate in 1918, so would be ideal for mowing down a few overgrown sparrows.

They were just birds. What could possibly go wrong?

Major G.P.W. Meredith of the Royal Australian Artillery was the man tasked with boldly leading the expedition. He was given a group of soldiers armed with the latest machine guns, plenty of ammo, and orders to eradicate the birds.

He was also told to bring the feathers back for hats.

Upon arrival, the farmers and Major Meredith set up an ambush, hoping to kill most of the birds in one stroke. The farmers drove the huge flock toward where the soldiers were hiding... Only to have the emus break up into multiple small groups instead of staying in a large one.

Out of thousands, the machine guns killed... only 12 birds. More were wounded, but the soldiers found that shooting an emu didn't necessarily slow it down. In fact, anything short of hitting a vital organ just made them mad.


"Don't fuck with us, you overgrown monkeys."

Undeterred, Meredith courageously set up another ambush, this time cornering roughly 1000 birds near a dam. His men opened fire at close range... again with only 12 dead birds after much shooting. And one of the pricey machine guns broke.

An ornithologist later wrote that "The machine-gunners' dreams of point blank fire into masses of emus were soon dissipated. The emu command had evidently ordered guerrilla tactics, and its unwieldy army soon split up into innumerable small units that made use of military equipment uneconomic." In other words, the birds quickly scattered, and were damn near impossible to hit.

With the marauding emus showing no signs of leaving, Meredith changed tactics. In a burst of inspiration (likely from that great American strategist Wile E. Coyote), he borrowed a truck from a farmer, mounted a machine gun on it, and sent it racing into the flock

Sounds like something from a comedy flick at this point, huh?


"Trust me. I'm a professional."

To the Major's horror, the birds were easily able to outrun the truck. And, as they drove over the uneven landscape, the vehicle bounced so much that his men were unable to aim, or even properly work, the gun.

This experiment in motorized warfare came to an abrupt end when a heroic kamikaze emu turned around and ran directly into them. It's body jammed the suspension, causing the truck to spin out of control and destroy a farmer's fence. History didn't record who paid for the damages.

After a few days of similar front-line combat, Major Meredith sent a report estimating 200-500 birds killed, though the number was likely closer to 50. He also credited his opponents, who were able to keep running in spite of multiple wounds. "If we had a military division with the bullet-carrying capacity of these birds it would face any army in the world" he wrote. "They can face machine guns with the invulnerability of tanks."

He also noted that his own forces had suffered no casualties.

One soldier later gave this assessment of the enemy's strategy: "The emus have proved that they are not so stupid as they are usually considered to be. Each mob has its leader, always an enormous black-plumed bird standing fully six-feet high, who keeps watch while his fellows busy themselves with the wheat. At the first suspicious sign, he gives the signal, and dozens of heads stretch up out of the crop. A few birds will take fright, starting a headlong stampede for the scrub, the leader always remaining until his followers have reached safety."

The good Major withdrew in defeat, but was ordered back. This time his forces were somewhat more successful in culling birds... But still unable to seriously dent their numbers, or get them to leave the area. Some basic number crunching found that, on his best day, it took an unsustainable amount of costly ammunition to bring down 1 emu. It was a war of attrition, and the emus had the numbers. Faced with being beaten by birds, Defence Minister Pearce ordered a withdrawal and wished the farmers good luck.

Eventually, as news of the heroic military operation got around, there was a debate in the Australian government. It featured this memorable exchange:


Mr. Thorby: "Who is responsible for the farce of hunting emus with machine guns mounted on lorries? Is the Defence Department meeting the cost?"

Prime Minister Lyons: "I have been told the Defence Department will not be paying the bill."

Mr. James: "Is a medal to be struck for this war?"


Another minister later commented that if such a medal were struck, it should be awarded to the emus.

Although the farming community would request military intervention against the birds in subsequent years, the lesson had been learned and no further emu wars were launched.

Today, along with the kangaroo, the emu is one of Australia's national symbols, showing just which side came out ahead in the brief conflict.


"Primates! You know where you can stick your opposable thumbs?"

Tuesday, November 4, 2014

Overheard in ER

Nurse 1: "I need another urine sample cup for room 17."

Nurse 2: "Didn't you just give him one?"

Nurse 1: "Yeah. I gave him the cup and a Betadine swab. I told him to wipe himself first, then put it in the cup. So he wiped his dick with the swab, then put the swab in the cup."

Monday, November 3, 2014

Halloween memories - epilogue

For those wondering after reading Friday's post...

This, in memory of my grandfather, is the tie I wore. He bought it as an honest-to-God ordinary tie that he wore to his job. It is truly one of my most prized possessions, because, let's face it, ties this hideous aren't easy to find.

Sure, you can buy lots of gag ties that are intentionally horrid, but what makes this thing so awesome is that someone designed it in the 60's-70's as a serious tie for men to wear to business meetings, Bar Mitzvahs, whatever. And my grandfather paid good money for it and DID JUST THAT.

The day I found it in his closet, I knew I'd stumbled on something rare and worth keeping. Someday I'm sure one of my descendants will do the same.

The picture doesn't do the bright colors justice. The vibrant reds, oranges, pinks, yellows, golds, whites, and a few previously undescribed hues make a pattern so striking... It looks like Roy G. Biv threw up.

Also, it's so wide at the bottom that you could wear a midriff shirt and no one would notice.


Yes, I really did wear it to work. Be jealous.

Friday, October 31, 2014

Halloween Memories

A long time ago, in a medical office building far, far, away...

As my regular readers know, before I went solo I worked for a large group called Humungous Neurology, Incorporated (HNI).

I left them for a lot of reasons, one of which (as is usually the case) was money. I won't go into too many details, but when I left my "contract-guaranteed" salary had been slashed by roughly 75% (to less than I'd made as a resident) because the money was needed for "the research budget."

By coincidence, my last day working for HNI happened to fall on Halloween.

So that day I came to the office (with a full schedule of patients) wearing an old pair of pants that I'd used to paint the house, a shirt with holes in it, a sock on only 1 foot, a pair of badly mismatched rundown shoes, and, for the pièce de résistance, this horribly hideous 70's era tie that I found while cleaning stuff at my grandparents' house.

When people asked me what my costume was, I told them I was an HNI neurologist, who couldn't afford decent clothes.

Thursday, October 30, 2014

Repeating oneself... a symptom of...

Medication list from a patient (highlights added).




For those not in the medbiz, Donepazil is used for Alzheimer's disease.

Thank you, Gary!

Wednesday, October 29, 2014

Skool Nerse time

This is Mrs. Grumpy.


Kid wanders into my office.

Nurse Grumpy: "What's up?"

Kid: (wailing) "I was playing in the sandbox and got sand all over my hands and under my fingernails!"

Nurse Grumpy: "Have you tried washing your hands?"

Kid: "Ummm... No."

Nurse Grumpy: "Go wash them in my sink over there. Use soap."

(Kid washes hands)

Kid: "It's all better now!"

Nurse Grumpy: "Okay, go have fun."

Kid: "I'm going back to the sandbox. What a neat trick!"

Tuesday, October 28, 2014

Doctor's lounge, Sunday morning, 6:18 a.m.

Cardiologist: "The coffee machine is broken."

Neurosurgeon: "Ah shit. I really needed some, too."

Neurologist: "I don't think they come in on weekends to fix it, either."

Pulmonologist: "They don't. We're fucked."

Cardiologist: "Maybe we can do something..." (Opens front of machine).

Neurologist: "Wow, what a mess."

Neurosurgeon: "I think this thing that fell over holds the used grounds."

Neurologist: "Yeah." (dumps grounds in trash, rinses holder in sink, puts it back in machine).

Nothing happens.

Pulmonologist: "It's still not working."

Neurosurgeon: "Let me see... Here, look. The part that feeds the filter paper roll got doubled up and twisted. It's stuck."

Neurologist: "Hang on..." (pulls out filter paper roll) "Ah, okay, looks like it wasn't put in correctly. Let me turn it around and toss the jammed paper."

Machine starts gurgling.

Pulmonologist: "It's working! Yay! Coffee!"

(All get coffee)

Cardiologist: "That's amazing."

Neurosurgeon: "The coffee gadget?"

Cardiologist: "No. For the first time in medical history it was a neurosurgeon who made the correct diagnosis, and a neurologist who fixed it."

The pulmonologist blew her coffee all over the bagels.

Sunday, October 26, 2014

Dog WIN!

Saturday, October 25, 2014

Christmakuh is coming

So, if any of you guys have horrifying gift ideas you'd like to submit for this year's catalog, please send them in!

Friday, October 24, 2014

It's just a jump to the left

Seen in a cardiologist's hospital dictation:



Thursday, October 23, 2014

Dear American Medical Association,

Thank you for the brochure I received from you and Mercedes-Benz, making me aware of the great car deals available to physicians.





I'm glad to see the AMA is still living in some sort of fairytale land where doctors have money trees growing in their yards. This sort of stereotype only fuels the already crappy image the public has of us.

Here's the reality: In 2013 (my worst year ever, due to several factors) Dr. Grumpy's solo practice salary came out to $99,354. That's working 60-70 hours per week, with 4 weeks of vacation.

Now, I'm NOT (emphasize NOT) complaining or bragging. I'm just stating this as a fact, to make a point. I know there are MANY people who'd be grateful to be able to make that. I'm thrilled to have a job I like that allows me to support my family.

But the reality is this: I drive a 14 year-old Nissan Maxima with the passenger door smashed in. Sending me a booklet telling me that, as a "qualified physician," I can save $1000 off a $92,000 S-Class sedan, $3000 off a $72,100 CLS-Class coupe, $4000 off a $116,000 CL-Class coupe, $3000 off a $114,200 G-Class SUV, or $3000 off a $106,700 SL-Class roadster... just shows me how fucking incredibly out-of-touch you guys are with the reality facing today's doctors.

Granted, I'm not a member of your organization. Honestly, I'd rather spend the $420 annual fee on my kids. To the best of my knowledge, an AMA membership gets me a journal I don't have time to read, discounted admission to an annual meeting I won't go to, and, obviously, a token discount on a car I can't afford. In fact, if I was a member, I'd be pretty pissed to find out this is what you were spending my annual fees on: getting me a deal on an imported car that costs more than I made last year.

American medicine is in a serious crisis right now. I'm not going to take political sides, as there are plenty of blogs for that. But my point here is that you guys are obviously clueless as to how much docs are really making.

Not to mention medical students. The next generation of docs are coming out of school $200,000 in debt. Residency pays maybe $40,000 a year, and they're at the ages where they're starting families, buying first homes, etc. Then they get to go earn practice salaries that (like mine) are dropping each year. So realistically the only "luxury automobile" they'll get to ride in... is a hearse.

Note to medical students- if you're doing this thinking you're going to get rich, just stop now and cut your losses. In fact, I'd get out regardless of why you're doing this.

But, I'm glad to see you AMA guys are on the ball. I'm sure there are SOME doctors out there who can blow that kind of money on a car (likely all on your board of directors) and it's reassuring to know you're doing something to benefit them.

The rest of us hard-working docs trying to practice ethical front-line medicine will stick with our old cars with the sides smashed in.

Wednesday, October 22, 2014

With a capital E

Mrs. Eword: "So, anyway, I want an MRI, and can do it today."

Dr. Grumpy: "I agree with getting one, but your insurance requires a pre-authorization. I'll have my staff get started on that, but it takes a few days and..."

Mrs. Eword: "I don't think you heard me. I want it NOW. While I'm here."

Dr. Grumpy: "Well, it has to be scheduled with an MRI facility and your insurance. I don't do them here."

Mrs. Eword: "What do you mean you don't do them here? You're a neurologist, aren't you?"

Dr. Grumpy: "Yes, and I order MRI's, but don't have the machine in my office. We use Local MRI, across the street and..."

Mrs. Eword: "I cannot believe this. What's that room I passed with the door closed down the hall here? There was a lot of noise. Isn't that your MRI?"

Dr. Grumpy: "Uh, that's the bathroom. They're replacing the sink's pipes today."

Mrs. Eword: "So you've been wasting my time this morning. Doesn't other peoples time mean anything to you? This is incredibly inconsiderate."

Dr. Grumpy: "I..."

Mrs. Eword: "I'll go elsewhere." (gets up, leaves)
 
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