MARY!!!!!!!!!!!!!!!!!!

Occasionally Mary puts a personal reminder for herself on the office schedule. I don't mind this at all. Usually it's something like "Order cake for party" or "Take kids to dentist".

BUT one of her friends is having a baby today.

So when I looked at my schedule this morning it featured this:

9:00- Suzy Migraine- Med check.
9:15- Phil Whiner- EMG.
9:30- Lisa Gravid - C-section at hospital.

January 31, 2011 - Happy Holiday!

Humans are a remarkably disparate groups of cultures, ethnicities, and religions. But there are some things we all share and cherish.

Today is one of those international holidays that helps unite us across the globe. A day when we all give thanks for those things that make a difference in our lives, in spite of our varying beliefs.

Yes folks, today is Bubble Wrap Appreciation Day.

I am not making this up.

Heaven knows that if we didn't have bubble wrap we'd still be packing stuff with abrasive paper, dirty socks, and seashells, and therefore opening packages full of scratched, smelly, computers, toys, and dishes.

To re-tell the ancient story that we traditionally teach our children on this day:

In 1957 two New Jersey engineers (Marc Chavannes and Al Fielding) were trying to make plastic wallpaper by gluing 2 shower curtains together, forming bubbles between the layers (it didn't sell).

In a flash, however, it was revealed unto them that their creation could be used as a cushioning and packaging material. And the rest is history.

So today, take a moment and give thanks for the marvel that has so enriched our packing and shipping lives, and given us (and our children) endless pleasure (not to mention stress reduction) in popping the little bubbles.

And we all say, Amen.

Memories...

It was the mid-90's. I was the neurology resident on call, and the attending was Dr. Footdrop.

She and I were gradually making our way around the hospital, but it was slow going. We had a lot of patients to see, and she kept getting calls from a crazy patient with millions of insane questions and complaints.

By late-afternoon Dr. Footdrop and I were on the 10th floor, rounding on the last few patients. There was a huge cellophane-wrapped tray of cookies in the middle of the nurses station, and we sat down to have some (it was the only food either of us had seen all day) and review the patients that were left.

While we were snacking, Mr. Crazy called for, literally, the 22nd time in 8 hours. Dr. Footdrop answered her phone, and spoke to him for about minute.

She suddenly leaned forward, and I thought she was getting another cookie. Instead, she grabbed a piece of cellophane. She held it next to the phone, began crinkling it up, and yelled, "I'm sorry, I've caught on fire, and can't talk!" Then she hung up.

Mr. Crazy never called back.

More great research

A recently published paper found this:

A guy is more likely to forgive his wife if she cheats on him with another woman, than if she does it with another man.

Here's the link.

And a grant was used to pay for this research. Because, I can only assume, we've now cured HIV, all forms of cancer, genetic disease, neurological illness, and all other types of human suffering. So now we can spend money on this stuff.

Thank you, Earl!

Oh, the humanity!

The world is running out of chocolate!

I, for one, am going to go hoard Peanut Butter M&M's (my favorite) RIGHT NOW!

Here's the story.

Thank you, Don!

Mary's desk, January 28, 2011

Guy comes in and stands at front desk.


Mary: "Can I help you?"

Mr. Dick: "Yeah. I'm a new patient, and I need to see Dr. Grumpy."

Mary: "Okay, let me get the schedule... What's your insurance?"

Mr. Dick: "You don't take my insurance. It's National Illness, Inc."

Mary: "No, we don't take that one."

Mr. Dick: "I know! You told me that last week when I called!"

Mary: "Okay, so what can I do for you?"

Mr. Dick: "Not a damn thing! I just came by to tell you that it really pisses me off that you don't take my insurance!"

Mary: "I'm sorry, sir, I..."

Mr. Dick: "And your cash price for an appointment is way too high! You people are absolutely unreasonable!"

Mary: "Sir, your insurance's website has names of neurologists who take your insurance."

Mr. Dick: "I already found one that does! Believe me! I just wanted to come by and tell you what a lousy practice you have!"

Walks out.

Whatever works

Dr. Grumpy: "How's the diabetic nerve pain been?"

Mr. Typetwo: "Awful. My feet burn constantly."

Dr. Grumpy: "Then let's increase the Neurontin dose..."

Mr. Typetwo: "No, I want to leave it as it is. The pain reminds me not to eat sweets."

Yeah, like that's going to happen

(click to enlarge)




Thank you, Ellie!

Failed biology, did we?

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

Mr. Guy: "My dad has diabetes and high blood pressure. My mom had a hysterectomy."

Dr. Grumpy: "Okay."

Mr. Guy: "Both my sisters had hysterectomies, too. Hey, does that mean I'll need one someday?"

"It's the family name, son. Try to live up to it."

I don't know what else to say. Just read it.

Thank you, Webhill!

Wednesday afternoon rant

The buzzword that's driving me nuts right now is "artisanal".

Nothing is a plain anything anymore. Stores sell artisanal breads. Restaurants advertise artisanal ravioli and artisanal sandwiches. Coffee places are pushing new artisanal blends. The word is every-fucking-where.

It makes me want to produce some artisanal vomit.

That's all.

Dear Marketing Bozos,

Thank you for this helpful sheet on things my patients should avoid to prevent migraines.






1. Head trauma. Wow! I was completely unaware that patients should avoid this. I figured it might toughen them up, and openly encouraged it. Perhaps I should rethink my opposition to seatbelts and motorcycle helmets, too.

2. Menstruation. I'll let all my lady patients know to stop doing this immediately. I had no idea it was under voluntary control, so I'm glad you told me.

3. Weather changes. I'll tell my patients to immediately move somewhere that has absolutely no weather changes. Like Pluto.*


* Actually, sometimes this doesn't sound like such a bad idea.

Oh, for hell's sake!

(I bring a new patient back to my office)

Dr. Grumpy: "Hi, ma'am, I'm Dr. Grumpy. Have a seat."

Mrs. Evil: "Pleased to meet you."

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

Mrs. Evil: "I used to see Dr. Brain, and I didn't like him. Do you know Dr. Brain?"

Dr. Grumpy: "Yes, I..."

Mrs. Evil: "Then I don't like you, either!"

(Gets up and walks out)

January 25, 1995

What were you doing on January 25, 1995?

Most of you probably don't remember. I don't, besides that I was in residency.

I bet you have no idea how close you came to dying (it was 2 minutes). Or, if you didn't die, having your life dramatically altered.

A Black Brant is a type of goose. It's also the name of a Canadian rocket routinely used for atmospheric experiments. It's launched with a bunch of instruments (depending on what's being studied) and the instruments are monitored during the flight. They then parachute back to Earth and are recovered for further data.

Black Brants are commonly used by Canada, the U.S., and several other countries for research. And so it was on this day in 1995.

A team of U.S. and Norwegian scientists launched a Black Brant from northwest Norway to study the Aurora Borealis. It contained standard scientific instruments.

But things - almost - went horribly wrong.

Routine notification of scientific and test launches is customary, and this one was no exception. 30 countries were told, including Russia. But due to layers of bureaucracy, the notice wasn't passed along their military chain. After all, the cold war had been over for 4 years.

As the rocket climbed, it was picked up by Russian radar early warning systems. It was on a trajectory that matched a predicted Trident missile launch from U.S. nuclear submarines in the Arctic circle. As it flew it also crossed an air corridor between American ballistic missile silos in North Dakota and Moscow, which resulted in Russian satellites tracking it.

The Russians read it as an American first strike. Both sides had practiced war games where a single high-altitude nuclear explosion from a submarine would be used to blind radar and satellites from the real attack, while the electromagnetic pulse would paralyze their defenses.

The Russian military went to full alert. Their ballistic missile submarines in the Arctic were all ordered to prepare for immediate launch. Silo crews on land were notified. Their targets would be the major cities of North America and western Europe. They knew the American/NATO forces would respond in kind.

The Black Brant used in this case was a 4-stage rocket. As it separated the radar pattern matched that of a ballistic missile with multiple re-entry warheads coming down, further convincing the Russians that an attack was underway.

The nuclear briefcase, with its launching codes, was brought to Russian President Boris Yeltsin. Like the Americans, the Russians use a mandatory 10 minute launch window (the time needed for a submarine-launched missile to reach either country). Yeltsin activated his nuclear keys to launch a counterattack- but waited for final verification.

At 8 minutes into the alert the rocket's course became clearer, and the Russians realized it was not incoming. With 2 minutes left before the mandatory nuclear launch time, Yeltsin deactivated the briefcase and ordered all nuclear forces off alert. The incident wasn't reported at the time.

The Black Brant rocket completed it's planned flight, landing near Spitsbergen and recovered. The scientists involved had no idea what had happened.

Did that story scare you? Then think about this: It's a single incident.

On November 9, 1979 the U.S. military was testing a radar training tape of what an incoming missile strike would look like. Unfortunately, while being tested, the tape was accidentally broadcast on screens at the American nuclear missile headquarters (NORAD).

The long range nuclear bombers in Alaska were ordered to take off to bomb Russia, while the command tried to verify the attack with other radar systems and satellites (which didn't show anything unusual). It took 6 minutes before an anonymous officer discovered the error, and the bombers were recalled.

We've all heard of Yeltsin, but have you ever heard of Stanislav Petrov? He's a retired Soviet military officer, now living in Fryazino, Russia.

In September, 1983 U.S.-Soviet relations were likely at their worst point since the Cuban Missile Crisis. To top it off, the Russians had just installed a new early-warning system.

On September 26, 1983, Petrov was the shift officer in command of the Soviet early-warning radar defenses. The system twice reported an incoming nuclear strike from North America, once with a single missile, a second time with 4.

Petrov, in a remarkably gutsy move, overrode the computer both times. He declared it an error and didn't pass the information to his superiors. His reasoning was based entirely on his gut instinct that the new system couldn't be trusted. As it turned out, he was right.

Petrov himself couldn't launch a strike. But both sides were on such a hair trigger at the time that if he'd passed the information farther up the line, most historians agree that his superiors would have assumed the worst and ordered a retaliatory attack.

You want more? During the Cuban Missile Crisis Vasili Arkhipov was First Officer on a submarine stationed in the Caribbean. His submerged boat was surrounded by American destroyers, who were trying to identify it.

The captain thought war between the U.S. and U.S.S.R. had started, and wanted to launch a nuclear torpedo. To do so required a unanimous opinion of the boat's 3 top officers. The other 2 wanted to launch, and Arkhipov refused. He argued so forcefully against doing so that the captain decided to surface, identify himself, and check with Moscow. The movie "Crimson Tide" was based on his story.

In only one incident was it actually a world leader who averted disaster. In the rest (and there are many others, read here, or over here) it was a few people (even one), considerably lower in the chain.

On this day in 1995 it was only 2 minutes. Just 120 seconds. Less time than it took you to read this.

Life on the edge is precarious.

Wow!

Dr. Grumpy: "What was your reaction to Penicillin?"

Mr. Chromatic: "It made me turn all kinds of funny colors. My wife said it was every color you see in the big Crayola box."

Public Service Announcement

Look, people- the police, paramedics, and firemen are busy enough as it is.

Calling 911 for stupid crap does not score you brownie points with ANYONE.

Especially if you do it 4 times for the same problem.

And that problem is a bad manicure.

Like this lady.

Sunday reruns

Due to an insane amount amount of kid activities today, I'm just putting up this post from 2009.


Before Viagra and it's cousins, there were other methods of waking Sheriff Woody. They're still out there, for those who have issues with Viagra.

One of them is Caverject (or Alprostadil for my pharmacy fans). This is fairly effective at getting it up for special occasions. They have to be pretty special, though, because Caverject has to be injected directly into your winkie to work. What fun.

Because it came to market before the era of direct-to-consumer celebrity advertising, we were fortunately spared TV ads featuring Eric Clapton singing (to the tune of "Cocaine"):

"If your lady is hot
Just give yourself a shot-
Caverject."

But I digress.

I have a patient who's been using Caverject for years. For whatever reason he can't use one of the newer drugs. He's kind of an aging, swinging, disco guy. In the 70's he was swinging, single, wearing gold chains, and picking up babes at the disco. In 2009 he's still swinging, still single, still wearing chains, and now picking up aging babes at the disco.

A few weeks ago he had a small stroke (he's fine now), and as a result he's now on Coumadin, a potent blood thinner. This gives new meaning to "Stayin' Alive".

So last Saturday he was out getting his boogie on and picked up Ms. Agingdiscoqueen. They went back to his place for some wild times. He shot himself up with Caverject and the fun began.

And abruptly ended. Apparently she got on top, and while she was riding the disco pony, blood began squirting out the side where he injected Caverject (thanks to Coumadin). Seeing blood flying all over those areas killed the mood fast. She ran out, and likely went home to douche with bleach.

He's been visiting me and his cardiologist today, to discuss stopping Coumadin.

Thus endeth the 70's.

Memories

It was the early 70's.

My dad has always been on the lookout for a good deal. On this day he took us to a Potluck auction. I don't know if they still have them, or what they're called now.

Basically, a moving/storage company auctions off unclaimed goods. Some of it is typical, like furniture, but the Potluck part is where they sell off big unopened packing boxes that were never picked up. So you have no idea what you're getting. Every bidder dreams of buying a forgotten box with something valuable in it.

I'd never been to an auction before. It was certainly interesting to watch and listen to. Dad bid on a few items that he didn't win. I vividly remember them dragging a large refrigerator out on stage. After the winning bid had been placed they were rolling it off for the new owner to claim, when suddenly the entire door fell off.

My parents spent time looking over the displayed boxes very carefully. Dad was particularly taken with one box. It was unusually heavy for it's size, and all bound up in tape and twine. It was, as best I remember, roughly 2-3 feet on each side. Across the top, in big letters, it said "TBC".

Anyway, at some point 2 guys carried the TBC box out, and the bidding began. Somewhere in there Dad entered the competition, and after a flurry of bidding, he'd won! My sister and I were excited, and cheered. We had no idea what had happened, except that our dad had won. The box cost $14.83 (including tax). I'd guess in today's terms it would be $50-$60.

It was HEAVY. It took both my parents and a guy pushing a dolly to get it out to the car, and I don't remember if the trunk closed all the way. We got home, and with much pushing and shoving got it into the kitchen.

Mom and Dad got out some knives and hacked their way through the heavy wrapping. We were all excited. It contained...

A Telephone Book Collection.

Yes, someone (who apparently needed a life) had collected phone directories from major cities all over the U.S.: Boston, New York, Miami, Chicago, Dallas, Seattle, Los Angeles, and many others. All neatly stacked in the box.

With quiet disappointment, the box was closed and put in the garage.

I'd forgotten all about it a few weeks later, when it was my birthday party. I had a bunch of friends over. We had the usual cake, presents, and games. And as they were getting ready to go my dad offered each kid... a phone directory.

It's been almost 40 years. I don't remember if any of them took one. Or what finally happened to the box.

Patients behaving badly

This morning I was on my usual hospital rounds, working at the nurses station. I absently noticed a patient pushing his IV pole around the hallways, writing on a notepad every now and then.

I dictated a note, moved to the next chart, reviewed some labs, scribbled a bit. The typical patient care stuff went on around me.

Suddenly, all was interrupted by someone loudly clearing his throat. "AHEM!"

We all looked up. Mr. Notepad was standing at the front counter.

Mr. Notepad: "I would like to speak to the nurse in charge."

Nurse Commander: "I'm the charge nurse today. What can I do for you?"

Mr. Notepad: "The decorative pictures in my room are not acceptable. I don't like them."

Nurse Commander: "I'm sorry."

Mr. Notepad: "I have prepared a list." (hands over a piece of paper) "I've written down the names and locations of pictures you have in the hallway that I prefer. I want to have them switched out with the ones in my room."

Long silence.

Nurse Commander: "Sir, this isn't a hotel or art museum" (hands paper back to him). If you're unhappy with the pictures, I suggest you make a donation to the hospital foundation, and send the list to them."


Mr. Notepad stomped back to his room. I went over to Nurse Commander and told her she was awesome.

Today's safety tip

DO NOT, under any circumstances, pour gasoline from open buckets and water bottles DIRECTLY into the engine of your car WHILE YOU ARE DRIVING IT!!!

Here's the story.

Thank you, Susan!

Guessing games

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

Mr. Anon: "Is he in today?"

Mary: "Excuse me?"

Mr. Anon: "Is he seeing people today?"

Mary: "Yes, can I help you?"

Mr. Anon: "I want to come in today."

Mary: "I'm sorry, but who is this?"

Mr. Anon: "I'm one of his patients and I want to see him today."

Mary: "What's your name?"

Mr. Anon: "I just want to make an appointment. If you can give me a time, I'll tell you my name."

Mary: "I can't give you an appointment unless you tell me your name."

(long pause)

Mr. Anon: "I'll just call back tomorrow." (hangs up)

Wednesday afternoon

Dr. Grumpy: "Are you allergic to any medications?"

Mr. Grief: "Penicillin... Doc, will this visit take long?"

Dr. Grumpy: "Maybe another 30 minutes. Do you have another appointment?"

Mr. Grief: "No, but my mom's funeral is in an hour."

Medical research

Okay, I'd like to thank Kayden for sending in another fine example of research.

The journal Alcoholism: Clinical & Experimental Research did a study on tailgating before sports events (football and baseball, specifically). They found that (GASP!) people who tailgate were MORE likely to get drunk than people who don't tailgate.

This came as a complete shock to me. I'd always assumed those people partying in the parking lot hours before a game were sticking to Diet Coke.

Here's the article.

"You mean we're smokin' dogshit, man?"

(If you recognize the title, it says more about me than I want to admit)

Okay, if you're a cocaine fiend, I know you're not particularly discriminating in what's going up your nose. I mean, you have to make sure it's not talcum powder or drain opener, but I don't think you're going to care if there's a little salt or flour or whatever.

On the other hand, breaking into a house and stealing just ANY powder to snort isn't a good idea.

As these guys found out.

Thank you, Carol!

Dear Main Line Health,

A reader sent me a copy of your invitation to an "all girls" activity.

While I, personally, have never had a mammogram (although Craig once slammed a dictionary closed on my chest), I've shown this to several ladies. And they had a few comments on it.

(click to enlarge)





"What's with the fucking mocktails? If you're going to slam my boobs between 2 ice-cold metal plates, the least you can do is buy me a REAL drink!"

"The only reason they're offering a manicure first is so I don't claw the tech to death."

"Define 'light refreshments'. Are we talking a bag of pretzels or some GOOD chocolate?"

"Who the hell is that skinny? I don't think either of them has boobs!"

"Gee, do you think they meant 'just for the girls'" as a double entendre?"

"Bryn Mawr? Can't they afford to buy more vowels?"

"Notice how they show a patient getting a manicure, instead of getting her breasts squashed."

"I don't want to see some stuffy 'expert' in a white coat. Can't they hire Chippendales dancers?"

"Is this a combo thing? Because if someone is trying to do a manicure on me, and I'm having my breast crushed at the same time, I'm not going to be holding still."

Sorry, no cape

I mentioned having a migraine this past weekend, and was somewhat surprised by how many people commented and wrote to me, surprised that a DOCTOR, let alone a NEUROLOGIST, would actually get migraines.

What's up with that?

I know this may be hard to believe, but WE GET HEALTH PROBLEMS, TOO.

I see this odd view surprisingly often. People who somehow expect us to be beyond the health concerns of non-doctors.

We may be doctors, but we're also humans. Prone to the same illnesses, bad luck, and erroneous judgments the rest of mortals are.

When I have to take a sick day (rare), and Mary starts frantically canceling people, most of them are fine with it. But we get the occasional person who gets angry because I'm sick. In their minds, apparently, that's impossible. So I must be making it up to go golfing.*

In 12 years I've had 3 patients change neurologists because I was sick and had to reschedule their appointments.

As a neurologist, I also take care of (gasp) other doctors! I have patients, who are also doctors, with epilepsy, MS, Parkinson's disease, and more routine stuff. I've seen young doctor's die with brain cancer.

Being a doctor doesn't protect you from the things that ail others. Including bad karma.

On the flip side, sometimes we're surprised when something serious happens to us. At times there seems to be an unspoken belief that by devoting ourselves to caring for others, it should magically protect us from those same diseases we fight. Nope.

If anything, the high stress nature of our work makes us MORE likely to have shit happen. We often ignore our own issues because of the time needed to care for others. Most of us live sleep deprived, caffeine-overdosed, and on food that we'd never endorse to you.

I chew out patients for not exercising, or a poor diet, or forgetting to pick up their prescriptions. But I likely do the same stuff as much as, if not more often, than they do. After a long day at the office and hospital rounds, and picking up kids, and Mrs. Grumpy having an after-work meeting, when the hell do I have time to pick up my Lipitor and get something decent for dinner? So I put the pharmacy off for another day and grab a pizza. And hope that over the weekend I'll find time to exercise. My average work week is about 60-70 hours. I doubt that's conducive to longevity.

So yes, I get migraines. And if you think your doctor is superhuman, they aren't. Even if they try their best to make you think they are.

*For the record, I've never golfed on anything other than a miniature course.

Whiskey Tango Foxtrot, Over?

My 11:00 today was a guy I've seen for years. He's a retired pilot, and now flies for fun. He shares a small plane with a couple other guys. During the appointment his cell phone rang.


Mr. Wright: "So now the pain is going down my right leg, and..." (cell phone rings) "Hang on doc... Hello? This is Orville."

(pause)

"Wilbur? I thought you were going flying this morning?"

(pause)

"Fuck. What's your altitude?"

(pause)

"Can you see an airport, or highway, or something?"

(pause)

"I'm sorry. Yeah, it was making a weird noise yesterday when I was up. Didn't I tell you about that?"

(pause)

"I could have sworn I did. It was loud, though, when we were talking. Maybe you didn't hear me."

(pause)

"That's pretty far out there, but you may not have a choice. Can Dave pick you up if you land there?"

(pause)

"Then call him, for crying out loud! I'm at the doctor's." (hangs up) "And my right foot has some numbness along here."

Riding the rapids

Okay, for the purposes of safety, we at Dr. Grumpy, Inc. generally DO NOT recommend using a sex toy as a flotation device.

We also suggest keeping your pants on under these circumstances.

Not like this pair.

Thank you, Alison!

Insanity

Due to the insanity of surviving a bowling party, night at Local Buffet, and the morning aftermath of a sleepover of 4th grade friends from the twins, I don't have much to write today.

A group of them decided to go out on the trampoline at 5:00 a.m., in pitch darkness and 23° F, and set off our burglar alarm in the process. The resultant cacophony of sirens, screaming, and barking did not help the migraine I had.

At the moment we are trying to cook pancakes. There is some sort of bizarre Wii game going on. And the dogs are still barking.

I need a nap today.

We will return to our regularly scheduled program tomorrow.

Saturday

My twins turn 10 today.

My dad turned 70 last week.

Why is it that my own birthdays never faze me, but those of others do?

Friday afternoon follies

Dr. Grumpy: "I want to do an MRI. Are you claustrophobic?"

Mrs. Webster: "Very. I can't handle heights at all."

MARIEEEEEEE!!!!!!!!!!!!

Last night, I was checking math homework. The question was, "What is the perimeter of a square where each side is 5 meters long?"

And, for the answer, Marie had written "Yes."

So I called her back and showed her that "Yes" is not the answer. I explained how you find the perimeter. She went back to her desk, and a few minutes later came back and said she'd fixed it.

Now the answer said "No."

Role Reversal

Today a lady in her early 70's came in, accompanied by her daughter. Since she was here for foot numbness, I had her take off her shoes. She had a small tattoo on the right foot.


Daughter: "Mom! When did you get a tattoo?"

Mother: "Well, I, a few months ago, I..."

Daughter: "Mom, how could you?!!! You know what I think of..."

Mother: "Lisa! I'm an adult! I can do what I want!"

But he doesn't look a day over 400!

On rounds last night, I discovered this line in a new patient's chart:

(click to enlarge)

Questions I'm sorry I asked

Mrs. Migraine: "I'm not sure I want to start any medicines, because my husband and I are thinking about trying to have children."

Dr. Grumpy: "Okay, when do you think you'd be starting?"

Mrs. Migraine (blushes): "Um, like today, during his lunch break."

Dear Americhoice Healthcare

On your website, you feature this picture under "Our doctors", and I'm honestly not sure what you're trying to say.





1. Our doctors are afraid to show their faces.

2. Our doctors are afraid of getting kicked in the genitalia.

3. Our doctors wear scrubs coordinated to make them look like a roll of Life Savers candies.

4. Our doctors are protesting against the new TSA scanners.

5. You're in good hands with our gynecologists and urologists.

6. We're so germaphobic here that our entire staff wears gowns & gloves.

7. "See no evil, hear no evil, speak no evil, don't touch my crotch."

8. We desperately need a manicure, but are wearing gloves so you don't see.

9. Americhoice pays us so poorly we can't afford clothes.

10. We have glow-in-the-dark scrubs so bright that even the color-blind will notice them.

Thank you, Nicole!

Mary's desk, January 11, 2011

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

Mr. Timepiece: "Hi! This is Mr. Timepiece! It's 10:55, my appointment is at 11:00, and I'm running late!"

Mary: "Um, actually, sir, your appointment is at 3:00 today."

(pause)

Mr. Timepiece: "Then I'm running early! Never mind!"

(click)

Medical research

While doing some Sunday hot tub reading, I came across a remarkable article in last week's Neurology Today (January 6, 2011, page 18).

Basically they caused rats to have a stroke by occluding an artery, and half of them repeatedly had their whiskers petted during this. They found that rats who had their whiskers stroked ("mild tactile stimulation" in medical talk) had less damage from the event.

Interesting? Yes. But to use the cliché, "further research is needed."

I have a hard time suddenly extrapolating this finding to humans (for one thing, we don't have whiskers, at least not the sensory type rodents have). We may be physiologically similar to rats, but we aren't the same.

Someone who's having a stroke certainly gets their share of "tactile stimulation"- family members holding hands, doctors & nurses examining them, IV's getting put in, blood drawn, blood pressure cuffs, etc.

But I don't see anyone showing that the touch component alone makes a big difference in Homo sapiens.

Not even in this guy.

I'm also not so sure how this could be studied. Since we don't have sensory whiskers, what do you touch in humans? Hair? Limbs? Ear lobe? And how do you sort out real tactile stimulation vs. placebo tactile stimulation? Touch only the side the patient can't feel anything on, since they won't know?

On the other hand, after many years in the trenches giving the so called "miracle clotbuster" TPA, I must say this new treatment (in my opinion) appears to be at least as effective as TPA, and a helluva lot safer.

Attention guys!

Penis enlarging methods are SCAMS. Regardless of what the email from Zlygovistan says, whatever they're trying to sell you WILL NOT INCREASE ANYTHING but your credit card bill.

If someone were to attach some sort of s-t-r-e-t-c-h-i-n-g device to my winkie, I think it would get pretty uncomfortable after a minute or so. Maybe some guys are into putting their private parts on the rack, but I'm not one of them.

But a truly determined guy in Quebec decided to give it, not 1 or 2 measly minutes of use, BUT 500 FREAKIN' HOURS OF PENILE TENSILE TESTING!!!

At the end of this tumescent marathon, with no visible improvement, he decided to sue the manufacturer.

His case, I swear, is being heard in small-claims court.

Here's the original news story.

Thank you, Webhill!

Monday morning, 4:53 a.m.

Get 15% off hello kitty scrubs with code "hellosale"

"Hey, um, this is Jennifer Jail, and my boyfriend is supposed to see Dr. Grumpy at 11:00 today, and kind of needs help in order to make that appointment, so I was hoping you'd call me back. We're trying to raise bail money to get him out by then, and if you can help that would be great. Otherwise he's gonna have to cancel the appointment. Thank you."

Skool Nerse Tyme

This is Mrs. Grumpy.

Since school started again last week, kids have been coming by my office to show me their new toys. So many cool things they didn't have when I was a kid.

I think it's absolutely great that so many of you parents gave your kids these new "spy camera" toys that can see in the dark and take pictures around corners and other stuff. It certainly gets their imaginations going. All last week I saw blurry shots of carpet, startled dogs, and sleeping siblings.

But my favorite were the ones I saw of Mrs. Claus wearing a Santa hat while riding St. Nick. Obviously, you guys were so involved that Junior had plenty of time to focus properly and get a few good pics. He also had a 10 second video clip, with sound.

Anyway, since they don't teach you how to handle these situations in school nurse class, I asked him to delete the files and not do that again. I told him to ask you guys if he had any questions about what you were doing. You're his parents, not me.

I also recommend that you guys learn to lock your bedroom door before playing "hide the yule log."

Happy new year!

Bedside manner with Dr. Grumpy

Mr. Aspirin: "Doc, I've had 2 strokes. The first was in 2007, when I was visiting friends in Canada, and the 2nd happened last month while I was at a Bible class. Does that mean anything?"

Dr. Grumpy: "Yes. You should avoid Canadian Bible classes."

Fortunately, he had a sense of humor.

Parenthood

Is when you wake up at 2:00 a.m., and realize you forgot to put money from the tooth fairy under your kid's pillow.

And you left your wallet out in your car.

So you find yourself barefoot, wearing only boxer shorts, in an unheated garage (28°F/-2°C) in the middle of winter.

And, because your wallet has slipped under the car seat, you have to kneel on the freezing concrete to try to reach around and find it.

It's hard to fall back asleep after that.

Criminal of the week

Okay, let's look at this:

1. If you burglarize homes, it is NOT recommended that you keep breaking into THE SAME ONE.

2. Unless you're a professional wine/beer/tequila taster it is NOT recommended that you drink heavily on the job, no matter what you do. This includes being a burglar.

3. If you ignore #2, get drunk on the job, and can't remember how to get out of the house, it is NOT recommended that you call the cops for help.

1, 2, 3, strikes, YOU'RE OUT! Like this guy.

Oooo! Tell me more!

This was left on Mary's voicemail during lunch today:

"Hello, this is Cindy Athome. I just got out of the shower, and I'm completely naked, and wet, and dripping on the floor, and I just realized I missed an appointment with Dr. Grumpy this morning. I'd like to reschedule, if someone could call me back. I can't come in right this instant, because I'm not wearing anything, but am going to go get dressed."

OH BOY! It's time for my pap smear!

Dear Medical Supply Catalog,

While I understand that attractive, Prozac-overdosed models may sell merchandise effectively, you should know that, in reality, NOBODY looks this happy about having to put on an exam gown.




Yours truly,

Ibee Grumpy, M.D.

Challenging case

Dr. Grumpy: "How did this all start?"

Mr. Lenz: "When I woke up yesterday, everything was blurry."

Dr. Grumpy: "Has it gotten better?"

Mr. Lenz: "Oh, it was fine as soon as I put on my glasses."

January 5, 1941

Amelia Earhart wasn't the only pioneering woman pilot, and there are others who should be remembered. One of the best died 70 years ago today.




The amazing Amy Johnson


Her name was Amy Johnson, and she was a legal secretary in London. But she was fascinated by the airplanes that were changing the world. In 1929 she earned both her pilot and engineering licenses.

Her father, in the tradition of all great dads, supported her dreams, no matter how far out of step with the times they were (Good Lord! Who wants a woman to fly a plane?!). He helped buy her first plane, a de Havilland Gipsy Moth, which she named "Jason".




Amy and Jason


She quickly began racking up records. The first woman to fly solo from Britain to Australia (1930). First person to fly from London to Moscow in 1 day (1931). From Moscow she continued on through Siberia to Tokyo (this flight set the world record for shortest flying time from London to Tokyo). Fastest solo flight from London to Cape Town (1932). It should be noted that the last bunch were human firsts- not just for a woman.

Although she later moved on to other planes, Jason was always her favorite, and is preserved today at the London Science Museum.

In 1933 she crashed in Connecticut while flying from Wales to the U.S., but quickly recovered.

When World War II began she volunteered for the ATA (Air Transport Auxiliary), flying aircraft from factories to front lines.

On this day in 1941 she was flying from Blackpool to Kidlington, on a mission that still remains a military secret. She may have been transporting another person.

In bad weather she went off course, and her plane crashed in the Thames river estuary. Amy was briefly seen alive in the water, but a rescue attempt by Lt. Cmdr. Walter Fletcher of H.M.S. Haslemere was unsuccessful (Fletcher himself died trying to reach her). Her body was never recovered.

She was 37 years old.

The cause of her death is listed as her going off course in bad weather, though there are also rumors that she was accidentally shot down in a "friendly fire" error.

Al Stewart, who I think is a great songwriter, wrote "Flying Sorcery" about her. I love the song, and in some ways it reminds of my own daydreaming daughter.


With your photographs of Kitty Hawk
And the biplanes on your wall
You were always Amy Johnson
From the time that you were small.

No schoolroom kept you grounded
While your thoughts could get away
You were taking off in Tiger Moths
Your wings against the brush-strokes of the day

Are you there?
On the tarmac with the winter in your hair
By the empty hangar doors you stop and stare
Leave the oil drums behind you, they won't care
Oh, are you there?

Oh, you wrapped me up in a leather coat
And you took me for a ride
We were drifting with the tail-wind
When the runway came in sight

The clouds came up to gather us
And the cockpit turned to white
When I looked the sky was empty
I suppose you never saw the landing-lights

Are you there?
In your jacket with the grease-stain and the tear?
Caught up in the slipstream of a dare
The compass rose will guide you anywhere
Oh, are you there?

The sun comes up on Icarus
As the night-birds sail away
And lights the maps and diagrams
That Leonardo makes

You can see Faith, Hope, and Charity*
As they bank above the fields
You can join the flying circus
You can touch the morning air against your wheels

Are you there?
Do you have a thought for me that you can share?
Oh I never thought you'd take me unawares
Just call me if you ever need repairs
Oh, are you there?


*Faith, Hope, and Charity were the names of the only 3 fighter planes that were available to defend British Malta during the dark days of early WWII, when the 3 were badly outnumbered by the German and Italian air forces. But they did it.

Let's do the time warp, again...

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

Mr. Sundial: "Hi, what time is my appointment today?"

Mary: "Um, you missed it. It was at 9:00 this morning."

Mr. Sundial: "What time is it now?"

Mary: "10:15 a.m."

(long pause)

Mr. Sundial: "So can I still come in at 9:00 this morning?"

Attention ladies!

While I recognize that everyone has their own definition of romance, I think I speak for the majority of human males when I say this:

It is generally NOT a good idea to call the cops on a guy, and falsely accuse him of attacking you, in hopes that the presence of an armed police officer will make him suddenly propose to you.

Like this lady.

Thank you, Suzanne!

Whatever

Mr. Blackout: "I fainted last weekend. The Emergency Room doctor said it was called Cinco de Mayo."

Dr. Grumpy: "Um, you mean syncope?"

Mr. Blackout: "Yeah, whatever."

Early morning hospital rounds

I'm sitting at the nurses station, reading a chart. A nurse comes over.

Nurse Query: "Dr. Grumpy, I have a question on Mrs. Stroke."

Dr. Grumpy: "Yes?"

Nurse Query: "You ordered a head and neck MRA?"

Dr. Grumpy: "Yes."

Nurse Query: "So you want us to do a head and neck MRA?"

Dr. Grumpy: "Yes."

Nurse Query: "Now, the hospitalist ordered a brain MRI. So should we cancel that?"

Dr. Grumpy: "No. They all need to be done."

Nurse Query: "You want a brain MRI? Even though you're already doing a head and neck MRA?"

Dr. Grumpy: "Yes."

Nurse Query: "Do we need to do a neck MRI, too? Since we're doing a neck MRA?"

Dr. Grumpy: "No."

Nurse Query (walking away): "I'm sorry, but these orders are confusing."

Pink medical scrubs? A black wig? And a Darth Vader mask?

Good heavens! Don't attempted bank robbers try to be fashionable anymore?

Thank you, Ami & Rob!

New Year's Resolution

Is your resolution this year to lose weight? (hell, that's been mine for the last 15 years) Are you sick of diets and exercise? Are you interested in a surgical gastric bypass for weight loss, but your insurance won't cover it?

Or are you interested in surgery, but don't like the idea of some stranger you've barely met seeing you naked and operating on you?

Well, Amazon has the answer for you!

Yes, for only $258.95 you can order your own laparoscopic bypass surgical kit! I AM NOT MAKING THIS UP!

Now (unless you don't have $258.95 + shipping) there's no reason for you not to have surgery. You can order this kit today, which (according to Amazon) features everything needed for the surgery. (NOTE- The kit for sale is new. Used kits are not listed, but I suspect they're cheaper).

Finally, you have the opportunity to improve your weight in the privacy of your own home, and don't have to worry about some surgeon (who you've just met, and who may not really be qualified) taking you to the OR. This time the surgery can be done by the person who knows your body best- YOU! Or, if you prefer, you can invite a few friends over. I'm sure they can help you figure out where to cut and what to do with the leftover pieces.

So what are you waiting for? Make this YOUR year! Order the kit, get a few bottles of strong whiskey for anesthesia (hell, it worked for frontier dentists), and invite friends over for a bypass party!

If you don't believe me, click the link here.

New year re-runs

I'm too tired and sick with the crud to write something new.

It's been a rough year for her, but at 15 Blackdog is still with us and doing better.

So I once again wish you guys...

A very happy New Year, from the dogs of Grumpy Neurology, Inc.




Zoom (Annie)





Spaz and Fizzy (Mary)





And last, but not least, Cooper, Snowball, and Blackdog (Dr. Grumpy)

Cooper isn't as fat as he looks. He's 80% fur. He got shaved down last week, and now weighs 12 lbs. And he DOES NOT like it, either.