Saturday Re-runs

Due to various amounts of family junk this weekend, I'm re-posting this from a while back.


As my regular readers know, I moonlight as a consultant for various medical market research companies. It's a thankless job, but somebody has to pay for the tomatoes.

So last night I had a dinner meeting with neurologists and sundry other specialists to review data on an up-and-coming product.

These are never fun, because neurologists by nature are a remarkably pathological group of personalities. Back when I worked at Humungous Neurology, Inc. the partners would argue if it was dark or light outside. I think they invite the other specialties to these as a buffer.

But I digress.

So I was seated next to Dr. Harangue, who I'd had the good fortune of not having seen in at least 5 years. In his own mind he's a giant in his field. To those outside his mind he's an obnoxious boil. He may have once been a good doc, but as they say in Hollywood "you're only as good as your last picture". And his was made before Casablanca.

Neurologists will argue over anything. The meal started with a dispute across from me over who's bread plate was who's (right or left? GET YOUR BREAD OFF MY PLATE!) followed by a fight over which fork is used for salad. Somebody actually dragged the maitre d' to the room to settle the issue (no, it wasn't me. I sit still and keep my mouth shut as much as possible).

I'm not much into the swanky places they have these meetings at. I ordered a steak. I had no idea how complex this was.

Waiter: "How would you like that cooked?"

Dr. Grumpy: "Medium."

Waiter: 'That involves a light red center. Is that okay?"

Dr. Grumpy: "As opposed to..."

Waiter: "Well, rare is a pink center."

Dr. Grumpy: "Medium is fine."

Waiter: "I can do medium rare, too. That's a pink/red combo".

Dr. Grumpy: "What's wrong with medium?"

Waiter: "I'll just do medium-rare-plus for you. That's a pinkish-red."

Whatever. I'm trying to order a steak, not pick out draperies.

Then the talk began. Every time a doc involved in the study was mentioned, Dr. Harangue felt the need to interrupt and say "I know that doctor personally. We've been close friends for over 25 years." By the end of the meeting I was hoping they'd mention a study done by Hippocrates or Woodrow Wilson to see if he knew them, too.

After 15 minutes of talking, the speaker stepped out from behind the podium to show us all that his zipper was down, with his tucked-in shirt hanging out of it. A tactful internist promptly yelled "Christ! Your fly is open!" to drop a subtle hint.

Then they brought dinner. The cardiologist next to me had ordered prime rib (no comment), and the waiter accidentally set my steak in front of him, and his prime rib in front of me. I pointed this out, and he quickly switched plates.

The cardiologist had a freakin' FIT! "I don't want that now! It was in front of him! He could have H1N1, or worse! Doesn't the heath department check you places anymore?!!!" It was, literally, in front of me for less than 5 seconds.

So I quietly started my steak, while they went to get Dr. Germaphobe a new prime rib (actually, I think they just brought him back the old one).

The next speaker showed us a seemingly endless series of graphs. After 20 minutes of this, she asked if anyone had any comments. Dr. Phlame at the end of the table immediately raised his hand. "Yes, I want to know why you chose red and blue as the main colors for the graphs. I think mauve and maybe yellow would be much more aesthetically pleasing. Also, I think some ruffles or curvy lines around the slide border would be nice."

This was immediately followed by Dr. Harangue chipping in "Dr. Phlame, do you live under a freaking rock? This company has been using those colors for years. But back to the data, did any of you people think to compare these results to a 1954 study by Longdead, et al?" The speaker (and everyone else there) had absolutely no clue what he was talking about, and Dr. Harangue chewed us out, as if it had just been published last week. When I looked it up, the study investigated a drug (that's no longer in use) for an unrelated condition.

Throughout this excitement the waiters kept refilling our glasses (ENDLESS DIET COKE HEAVEN!), so dysfunctional personalities were not improving with repeated doses of Burgundy and other wines.

In one discussion, to argue a point about a competing drug, an internist actually reached into his pocket and pulled out a product insert. I swear! He had it with him, all scrunched up. After reading from it like it was a bible he sat down and began arguing with a pulmonary doc about when daylight savings time starts.

We made it through another 15 minutes of polite discussion before Dr. Germaphobe cardiologist began tapping my shoulder. "Hey, Ibee!"

I turned around "What's up?"

"Are you gonna finish your roll?"

Stunned, I looked at the bread roll I'd absently left on my plate. It was buttered, and I'd taken a few bites out of it. "Uh, no, I'm full".

"Thanks!" And he grabbed it. So the guy who'd refused to eat an untouched steak was now chomping on my partially eaten dinner roll. Amazing what a bottomless glass of wine will do.

As we sat through another set of slides, Dr. Harangue's cell phone rang. He answered it, speaking loudly enough to be heard in the next county (i.e., his usual volume). "What? Yeah. No, I've got another half hour of this shit. The drug company people won't shut up."

The dinner ended 20 minutes later. To make sure all points were covered, the moderator specifically asked "Dr. Harangue, are there any other comments?"

No answer. It was the only time he'd been quiet all night. He was in a burgundy stupor, slumped face down next to his creme bruleé. He was still there when I collected my paycheck and left.

Crime in America

Words fail me.

Just read it.

Thank you, Deborah!

Highway safety

Dr. Grumpy: "What do you do when you feel a migraine coming on?"

Mrs. Hazard: "Exercise helps. I do some stretching and jog in place for a few minutes, and this keeps it from getting worse."

Dr. Grumpy: "Okay, so..."

Mrs. Hazard: "And I need a note from you to get me out of this." (pulls out papers).

Dr. Grumpy: "What is this?"

Mrs. Hazard: "It's a traffic ticket."

Dr. Grumpy: "I see that..."

Mrs. Hazard: "I was driving on the freeway and felt a migraine coming. It was rush hour, I didn't know when I'd get home, and the road shoulder was closed for construction. So I stopped in my lane so I could get out and jog in place next to the car, and this highway patrolman gave me a ticket. I don't get it, either, because I'd turned on my hazard lights. The other lane was open, so it wasn't like I was completely blocking traffic."

Random dialing?

My cell phone rings. It's the hospital ID.

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

Dr. Noclue: "Hi, I'm the hospitalist taking care of Mrs. Lois Lane, and I need to refer her to you, for outpatient follow-up."

Dr. Grumpy: "Okay, how can I help?"

Dr. Noclue: "Do you take Major Illness Insurance?"

Dr. Grumpy: "Yes."

Dr. Noclue: "Okay, I will give her your number and have her see you in a week. One more question, if I may."

Dr. Grumpy: "Sure."

Dr. Noclue: "What is your specialty?"

Amazing coincidence

Dr. Grumpy: "Are you and your brother fraternal or identical twins?"

Mr. Gemini: "Ummm, we're the kind where we both have the same parents."

Mary's desk, April 26, 2011

A new patient filled out our info sheet, with his address and phone number, then handed it back to Mary.

Mr. Patient: "Can you copy that for me?"

Mary: "Excuse me?"

Mr. Patient: 'I want a copy for my own records."

Mary: "Sure... But all it has is your own address and phone number. You just filled it out yourself."

Mr. Patient: "I want a copy of it. I know how you people work."

Today's criminal tip

Let's keep this in mind: when using your driver's license to jimmy open a locked door, you SHOULD NOT leave it there afterwards.

Like this guy.

Thank you, Lisa, for sending this in!

Quality

Sometimes a company stops making a drug, or runs behind, or has a production stoppage for whatever reason.

When this happens I typically get a fax or call from the pharmacy, telling me about the manufacturer's problem, and asking me to change to another product.

I'd like to thank my reader Jenny. When a similar fax showed up at her office, she sent it on to me:

(click to enlarge)

I'd avoid drugs like broccoli and grapefruit

Mr. Nature: "I don't believe in medicines, so my cardiologist is treating me with supplements."

Dr. Grumpy: "Which ones?"

Mr. Nature: "Coumadin and Lipitor."

Things you hear on call

I was on call this weekend, and during my appointed rounds I overheard the following quotes, which you won't normally hear outside a hospital:

"I cleaned it up. I can clean up vomit like nobody's business."

"You should have seen her on the toilet! She pees like a mad woman!"

"He has scabs all over his penis from scratching it. It's gross. There's more scab than penis."

Nurse Night: "I told the lady in room 37 that I liked her hair style."
Nurse Day: "Yeah, I think it's a good one, too."
Nurse Night: "She took it off and handed it to me!"

Sociology 101

Yesterday we took the kids to Local Family Fun Place. As I watched them on a ride, two mid-teen girls went by, and I got to witness this:

First girl: (aggressively picking nose): "I don't like this place. We never meet any cute guys here."

Second girl: "Yeah. I wonder if we'd have more luck at the arcade. BURP!"

First girl: (eats booger) "We'll go there next time."

Random pictures

Due to trouble waking up today, I simply present a pair of pictures.

The first was sent by a reader who says he took this one of a store somewhere on the Iberian peninsula (obviously, he violated their "no pictures" policy, as seen in the bottom left corner).






The second is from a reader who says she was taking an online survey about grocery shopping, and discovered this multiple choice question.

(click to enlarge)

Anatomy

Mr. Notochord: "I have all these tumors! Right there, on my back!"

Dr. Grumpy: (examining patient): "Ummm, okay, where?"

Mr. Notochord: "It's a whole row of them! In a straight line, going down the middle of my back! They're really hard when you press on them."

Dr. Grumpy: "Sir, those aren't tumors. It's the vertebral bones of your back."

Mr. Notochord: "That's what all the other doctors say, too! Why doesn't anyone believe me that they're tumors?!!! This is so frustrating!"

Today's criminal tip

Look, if you're going to rob a convenience store, IT IS NOT recommended that you hand over a note with your name written on it.

Especially if it's paperwork pertaining to your previous encounters with the law.

Like this guy.

Holy SPF 55, Batman!

I'd like to thank my reader Jeanette, who says this card was mailed to her office recently.

Dear Ms. Rutkowski,

Your business card was forwarded to me by a reader this week.

I must say, that in all the years I've dealt with various answering services, it never occurred to me that the operators lived in tanning beds.





If I'm wrong, and that happens to be your normal skin color, I'd suggest you see a dermatologist. They should be back from New Orleans by now.

p.s. I love the vintage green phone handset.

Patient quote of the day

"Doctor, my husband and I just got back from a trip to the Holy Land. Do you know that mostly Jews and Arabs live there?"

Mary, I'm going to go work at Big Lots.

Dr. Grumpy: "Are you on any medications?"

Mr. Forget: "I take Norvasc, for my blood pressure."

Lady Forget: "No, you take Cartia. I take Norvasc."

Mr. Forget: "It says Norvasc right here, on my list."

Lady Forget: "That's my list."

Mr. Forget: "It doesn't have a name on it."

Lady Forget: "Hmmm. Maybe I do take Cartia."

Mr. Forget: "Doctor, I take one kind of blood pressure pill, and she takes another. Is that good enough?"

BWAHAHAHAHAHAHA!!!

14 DAYS, 3 HOURS, 27 MINUTES!!!

AND DR. PISSY HAS CRACKED!!!





Welcome to the dark side, young Skywalker...

Skool Nerse Time

This is Mrs. Grumpy.

Dear Teachers,

As we all know by now, there was a small fire yesterday in Building 7 at Douglas C. Kenney Elementary School. It involved a storage room with some paint and wood. Fortunately, between the sprinklers and the fire department, it was out quickly with only minimal damage.

As your school nurse, responding to the fire alarm is part of my job. After all, someone might be injured. So when the siren went off I grabbed my first aid kit & stethescope, and skeedadled over. I didn't grab my umbrella, which I should have because it was lightly raining.

When I got over to Building 7, with the alarm blaring and smoke coming out of the utility room, I was somewhat surprised to see NOBODY outside, in the orderly lines that you do so well during fire drills.

I was even more surprised to find all students in their room, with teachers, continuing regular lessons (albeit shouting loudly over the alarm).

Let's review:

When you hear the fire alarm, take your students and GO OUTSIDE!!! When I ask teachers WHY THE HELL everyone is still inside, "Because it's raining" IS NOT an acceptable answer. I don't care if the children don't have coats/ponchos/umbrellas. It wasn't even that heavy, for freak's sake.

When I do finally herd your stupid butts outside, telling your kids to stay dry by standing under the wooden overhangs that are connected to the building IS NOT a good idea. You are supposed to get far away from the building, to the corners of the playground.

We practice this damn drill 4 times a year. So when it really happens, WTF can't you carry it out?

Mental Imagery

As I was leaving the hospital tonight, I noticed this sign in the doctor's lounge:

"Medical Grand Rounds this week: Pushing the train out of the tunnel- New treatments for constipation."

Sunday night, 8:55 p.m.

"Hi, this is Liza Shakin. I had a seizure today. You don't need to call me back, I just wanted to let you know. I'm in ER, and they're going to do a CT scan and some labs to find out why I had one. Anyway, I'm calling to leave a message for Annie, because I need my epilepsy pills called into the pharmacy since I ran out 2 weeks ago, and I keep forgetting to ask you guys for more. Thank you."

Life in Line

I went to Costco yesterday to stock up on Diet Coke and return a video game.

The lady in front of me in the return line had one of those outdoor heaters (the tall ones, like you see at restaurants) in a cart. But it was in several pieces, scarred black with fire & smoke stains, with the metal twisted, and in some places melted. It had clearly had some sort of catastrophe.

So the guy at the counter takes her receipt, and says "Was there a problem with the item?"

"Hey, wasn't this in an Alfred Hitchcock film?"

I guess there are ways to kill people that aren't in the game "Clue".

Such as this.

Thank you, Webhill!

And yes, she was serious

Dr. Grumpy: "Any history of cancer in your family?"

Mrs. Twelfhouse: "No, my parents were both Pisces."

Reasons I use Rogaine

Mr. Doofus: "I had an MRI at Megatron Imaging in 2007."

Dr. Grumpy: "Hang on..." (picks up phone, calls Megatron Imaging) "Hi, it's Dr. Grumpy. Do you guys have an MRI on William Doofus? No? Are you sure, from 2007? Okay, thank you." (hangs up) "Sir, they don't have an MRI on you at all."

Mr. Doofus: "I changed my name in 2009. I had it legally changed to William Doofus."

Dr. Grumpy: "What was it before?"

Mr. Doofus: "Howard Moron."

Dr. Grumpy: (dialing Megatron MRI again) "Why didn't you tell me that in the first place?"

Mr. Doofus: "Because I don't like being called Howard."

April 14, 1912

The story of the Titanic's band, playing to the end, has an honored place in history.

Even the last song they played still remains debated (it was likely a popular ragtime piece called "Songe d'Automne", not the hymn "Autumn" and almost certainly not "Nearer My God to Thee" as commonly believed).

But, for all their bravery, so much about the band is unknown.

They were all employed by C.W. & F.N. Black, a talent agency with a monopoly on supplying the British Atlantic steamship trade in 1912. If you wanted to work on the ships, you shut up and signed with the Blacks, and took whatever they offered. In 1912 it was roughly $6 (USD) per month. You had to buy your own uniform.

The musicians really worked for the Blacks, NOT the steamship company. So they technically were passengers, not crew. To get around this White Star Line listed them as 2nd class passengers, who just happened to have free tickets. Of course, they didn't actually get to stay in the decent 2nd class cabins- on the Titanic the musicians were stuck in crew quarters next to the potato washer.

Even worse, since they were passengers, when they arrived in New York they had to go through immigration and show that they each had $50 (borrowed from family at home) to prove they weren't destitute- even though they then immediately had to get back on the ship to start preparing for the return voyage.

What often isn't realized, either, is that the Titanic had 2 bands- one for the 1st class dining room (5 members) and a 2nd for the Café Parisien restaurant (3 members), that had entirely different arrangements.

And so that night, with the Titanic slowly sinking beneath them, these 8 "passengers" played together for the first time. Unlike the other passengers, who were trying to get into lifeboats, these 8 men stayed on, trying to calm people with music until the sloping deck made it impossible to do so.

As best as we know, they were not ordered to do this. They each chose to. And so they all died in the icy waters of the North Atlantic, 99 years ago tonight.

But the story, tragically, didn't end there.

Jock Hume was a violinist in the band. On April 30th, 1912, his grieving parents received this kind letter from the Blacks talent agency:

"Dear Sir, We shall be obliged if you will remit to us the sum of 14 shillings, which is owing to us as per enclosed statement. We shall also be obliged if you will settle the enclosed uniform account.

Yours faithfully,

C.W. & F.N. Black"

The statement included charges for their son's uniform (by now, along with him, at the bottom of the ocean) and costs for a lyre lapel insignia & sewing White Star Line buttons onto his jacket.

Many of the musicians left families behind, who asked the White Star Line for compensation for their loss. After all, they were covered under the Workmen's Compensation Act, weren't they?

Nope. White Star Line responded that the bandsmen were, after all, just passengers on the Titanic. Since they weren't crew members, they weren't covered at all.

So the families asked the Blacks to help. The talent agency had insured it's employees, and told the families to contact the insurance company.

And what did the insurance company do? Well, they said the bandsmen were independent contractors, using the Blacks as a booking agency only, and were, after all, just 2nd class passengers on the ship, not employees.

So in spite of the brave deaths of their loved ones, the families were not going to be compensated at all. A judge ruled in favor of the insurance company, that the musicians were voluntary passengers, and therefore not employees of anyone.

Fortunately, a large charity set up after the disaster, The Titanic Relief Fund, decided to help support the bandsmens' families like those of other lost crewmen. The memorial flier at the top of this post was sold on street corners in 1912 to raise money for them.







Wallace Hartley was the bandleader, and 1st violinist, for the Titanic, and likely the one who organized the other musicians to stay until the end. He was engaged to be married, and had reluctantly accepted the Titanic job (he wanted to get out of being a ship's musician) to try and make contacts for future work. He was 33 years old.

His body was found floating off Newfoundland a few weeks after the disaster, and (to my knowledge) is the only band member ever recovered. He's buried in his hometown, Colne, in Lancanshire. The opening notes of his favorite hymn "Nearer My God to Thee" are inscribed on the base of his grave marker, above a violin.

Love and marriage

Dr. Grumpy: "How's your memory been?"

Mr. Amana: "I'm doing fine."

Mrs. Amana: "You're NOT doing fine! Last night you couldn't even remember how to work the microwave!"

Mr. Amana: "So what? It's the most complex damn thing in the house."

Mrs. Amana: "That's beside the point. I have no trouble working it."

Mr. Amana: "Could have fooled me. I have to eat your cooking."

Home life, Tuesday afternoon

Mrs. Grumpy: "Hello?"

Phone girl: "Hi, I work for Bozo's Air Conditioning, and we need to schedule a time to come install your new unit."

Mrs. Grumpy: "I scheduled it with you last week, for this Wednesday."

Phone girl: "Why yes, it is scheduled for Wednesday. Do you mind if we do it on Thursday instead?"

Mrs. Grumpy: "I can't on Thursday. I already scheduled a substitute nurse to cover me on Wednesday."

Phone Girl: "Oh. Sorry. We'd just prefer to do it Thursday, because that day is empty, and we already have an installation scheduled for Wednesday."

Mrs. Grumpy: "I need to do Wednesday. How many other installations do you have listed for that day, anyway?"

Phone girl: "You're the only one."

Today's criminal tip

Remember, people, when stealing a car, you SHOULD NOT ask the police to help you pay for gas.

Like this guy.

High maintenance

Yesterday afternoon I was in my office, waiting for a new patient. Mary came back, and told me I needed to come talk to the patient's wife at the counter. So I went up front.

Dr. Grumpy: "Can I help you, ma'am?"

Mrs. Wife: "Yes, my husband is down in the car."

Dr. Grumpy: "Is he okay?"

Mrs. Wife: "He's fine, but it's raining."

Dr. Grumpy: "Yes."

Mrs. Wife: "He hates rain."

Dr. Grumpy: "Uh-huh."

Mrs. Wife: "Look, can you come out to the lot and do the appointment in the car?"

Dr. Grumpy: "Why can't he come up here?"

Mrs. Wife: "He doesn't like the rain."

Dr. Grumpy: "Do you need an umbrella? I can loan you mine."

Mrs. Wife: "He doesn't use umbrellas. He's superstitious."

Dr. Grumpy: "I'm afraid I can't help you. I don't do car calls."

Mrs. Wife: "Can I reschedule to after the rainy season is over?"

Mary (pushing me aside, handing lady a paper): "No. Here are the numbers of other neurologists in the area. Try them."

Run that by me again

Mr. Confuseme: "My mother had Alzheimer's disease."

Dr. Grumpy: "How old was she at the time?"

Mr. Confuseme: "Like really old. She was almost dead. Maybe it was after that. Can you get Alzheimer's after that?"

The art of conversation

I went in to the hospital on Saturday to see a longtime patient of mine. As I was riding up to the 7th floor two guys, both with huge beards, got on the elevator with me.

Guy #1: "It's just shit. I mean, all that shit, ya know, and no real shit to show for it. I'm tired of this shit. Shit, I'm gonna tell her that, cause neither of us needs this shit, and it's just gonna cause more shit, and at some point, shit, it's time to find some other shit to work on. I just don't give a shit anymore."

Guy #2 "Yeah, no shit."

Mutant Kiwi Fruits

Last week I put up a post on the vaguely pedophilic ad for Kiwi fruit that I saw at Local Grocery.

In an unanticipated turn of events, my reader Merinz sent in this picture of a fruit that she picked off her own kiwi plant.

And I have nothing else to say.

Neuronerds in paradise

This week, folks, is the 2011 American Academy of Neurology meeting, being held in Hawaii. Of course, I'm not there. If I'm going to go on a vacation, it would be to GET AWAY from other neurologists.

But, a friend of mine who's there sent me this picture today. For those of you who didn't believe my post about how fanatical the neurobrotherhood is about reflex hammers, consider this: There are LOTS of totally awesome things to do in Hawaii. And what do neurologists do? We go ogle reflex hammers.

And WTF is a POS Taylor Hammer doing in there?!!! You people should be ashamed of yourselves!

(click to enlarge)

My readers write

Bruce writes in with today's post. He's a yak herder north of me, in the foothills of Mount Wannahockaloogie. Today, however, he's pretending to be a pediatric lung specialist.

Until recently I thought there were just 4 classes of smokers identified by their answer to the question "Do you smoke?":

1. The righteous nonsmoker who responds, "We do not, and anybody who lights up around my child will be shot on sight"

2. The rabid smoker "Yeah - and so what? Anyone who bugs me about my smoking is shot on sight". This guy always has the most interesting messages on his t-shirts.

3. The drive by smoker comes into clinic smelling like a Carolina tobacco barn. She doesn't smoke herself but her clothing stinks because her (husband, girlfriend, dog, neighbor) smokes. I have been tempted to suggest she take off all her clothing whenever she's around her (husband, girlfriend, dog, neighbor).

4. The nature-loving smoker is the most common type that I encounter. She only smokes outside; never around the kids. All the plants in front of her house are dying.

Recently I met a new variety, who also never smokes around the kids. He told me that "when we smoke we send the kids outside, so they don't breathe it in". I dared not ask what they did when they wanted to smoke while driving.

I also get very interesting responses when I ask if children have allergies. Not long ago I had parents refuse to give their wheezing boy any asthma medication because he was allergic to chemicals, like in medicine, but not allergic to anything organic. I refrained from discussing organic chemistry and that almost all modern medications are organic compounds. There was no future in that conversation.

I did, however, review the results of their son's allergy tests showing reactions to moulds, house dust mites, and the organic family cat. These concerned carbon-based life forms replied that all the results REALLY showed was an allergy to the chemicals used in making the needle used for skin prick testing.

I will retreat now, to my aluminum-clad safe room.

Pop quiz

Okay, it's time for another quiz. Get out your #2 pencils, and let's test your medical knowledge.


You have a history of heart problems, and been having crushing chest pain for the last week whenever you exert yourself, so you:

A. Go to the ER, like your cardiologist told you to.

B. Go to the ER, like your internist told you to.

C. Go to the ER, like your wife told you to.

D. Listen to some guy (who owns a furniture store) that you met at a cocktail party, who told you it's just a pinched nerve and you should go see a neurologist.


If you answered (D), it was a pleasure meeting you yesterday, sir. I'm sorry it was so brief, but if you hadn't run up the stairs to get to my office we likely wouldn't have had to call 911 as soon as you hit the lobby.

Thursday morning, 7:55 a.m.

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

Miss Shakin: "Hi. This is Cindy Shakin. I only have one dose left of my epilepsy medicine, and my mail order hasn't come yet. Can I get a few days of sample pills from your office until it gets here?"

Dr. Grumpy: "No problem. I'll put some up front with Mary for you. What time will you be in?"

Miss Shakin: "I have to work... Can I send my new boyfriend to pick them up?"

Dr. Grumpy: "Sure. What's his name?"

Miss Shakin: "Hang on..." (thunk as she puts phone down) "Hey! Wake up! Come on! You took all the covers. Hey, what's your name, anyway? No, I don't remember. I was drunk." (pause, comes back to phone). "He says his name is Dave. So a tall guy named Dave, with, um... dark hair, will be by today. Thanks."

"Hey, want some fruit?"

Yesterday afternoon I stopped at Local Grocery to pick up some tomatoes, and noticed this sign in the produce section.

I think the marketing people need a better slogan.

Yep

Mr. Kinetic: "Sometimes I'm more shaky, sometimes less."

Dr. Grumpy: "Any triggers? I mean, have you noticed anything that makes you more or less shaky?"

Mr. Kinetic: "Um, well, when I'm less shaky, then I guess I haven't been shaking as much."

Money at work

A few weeks ago Mr. Tachy called my office in a panic. He was at the gym, on one of those machines that monitored his pulse. At one point it said his heart rate was 210.

He panicked, and got off it. He felt like his heart was pounding. He was terrified.

He called my office (NO! I have no idea why he called his neurologist!). Annie sent him to ER. Of course, he didn't go. He drove to his internist instead.

His internist did an EKG, which was fine by that point, and some labs. All fine. So he sent him to a cardiologist.

The cardiologist did all kinds of expensive stuff, and couldn't find anything. So she referred him to a cardiac electrophysiologist. They did more expensive testing of the heart's circuitry, again without any answers.

So after several weeks, 3 doctors, lots of tests, and a crapload of money we knew what he DIDN'T have, but still had no idea why his heart had done that.

Yesterday he came to see me for the first time since this all happened. I asked him if he'd gone back to the gym yet.

"Yeah, I started last week. Guess what? It turned out the machine was broken. It read a pulse of 210 on everything, even when nothing was connected to it."

Afternoon interlude

Dr. Pissy: "Ibee, did you see that article a few months ago about diet soda being linked to stroke?"

Dr. Grumpy: "Yeah, several readers sent it to me."

Dr. Pissy: "What do you think?"

Dr. Grumpy: "It's concerning, but I'd have to see more solid data before I believe it. I mean, we've both seen plenty of research, like Saccharin in the 80's, that said it did something awful that later turned out to be incorrect."

Dr. Pissy: "I agree with you, but... I think I'm going to stop drinking Diet Coke. I've been wanting to give it up anyway. I've got a few cases left, but I'm just going to go cold turkey off it."

Long pause.

Dr. Grumpy: "Then can I have yours?"

Annie's desk, April 4, 2011

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

Mr. Goodyear: "Hi, Dr. Grumpy referred me to a cardiologist, and I made an appointment for tomorrow. I'm stuck out of town on business now, and there's no way I'll be able to make it. Can you call them and cancel for me?"

Annie: "Sure. What doctor is your appointment with?"

Mr. Goodyear: "I have no idea. It's on my desk at home. It was someone on the list."

Annie: "What list?"

Mr. Goodyear: "The one from Major Illness Insurance, of cardiologists on the plan."

Annie: "Hang on, let me look it up online... They have 38 cardiologists in our area. Do you have any idea who it may have been?"

Mr. Goodyear: "No. Can you just call all of them for me?"

Party on, dude

Mr. Astalt: "I used to be a heavy drinker, like 1 or 2 full bottles of vodka a day. But I want to be healthy, and don't do that anymore."

Dr. Grumpy: "How much vodka do you drink now?"

Mr. Astalt: "Maybe a quart per day."

Doctors Behaving Badly

Yesterday morning I got dragged from my Sunday sleep-in to see a hospital patient.

As usual, I swung by the doctor's lounge for some morning nourishment, namely a Diet Coke and miscellaneous baked good.

In the tray of muffins, I encountered this:





What is it you ask? Well, let's unwrap it:





Yes, folks, it's a banana-nut muffin that one of my esteemed colleagues gnawed/cut/pulled the top off THEN WRAPPED BACK UP AND RETURNED TO THE TRAY!!!

I decided to just have a bagel.

Back to the artisanal mailbag

Ever since I began whining about the horrific overuse of the word "artisan" and it's derivatives a while back, you guys have been inspired to send in examples.

Due to surprisingly popular demand, I've created a webpage just for this insanity. It's down on the right sidebar, listed with my other specialty page on history stories.

As always, you guys sent in A LOT of stuff. I'm only going to post a few at a time. So if yours isn't up today, don't worry. It likely will be in the future.

And now it's time for (drumroll please):






One of you wrote that you have a free GPS service, which occasionally posts screen ads. And when you drove by an Olive Garden restaurant, you got this:






Artisanal, by definition, means "hand made by a skilled craftsman". As much as I like Costco, somehow I don't think their mass-produced pizza fits that category.






Even fast-food giant Wendy's is doing it. They also get bonus points for putting another overused annoyance, "panini" onto the same menu page.






With your artisanal breakfast you'll want coffee...





Some of you, however, may prefer to stay home and prepare meals with artisanal kitchen appliances (in great colors, too!)




But don't eat TOO much or you won't fit into your swimsuit!






And if all this artisanal crap makes you want to vomit, maybe it's time to head for the toilet.

Saturday re-runs

Due to yet more Scouting activities today, I'm re-posting a touching ICU moment.


This morning I was called to evaluate a 23 year-old lady who was found
floating face down in her pool. Probable suicide attempt.

While I was writing my chart note a nurse came over to tell me that the
patient's fiancé was on the phone, and wanted to talk to a doctor about
what was going on. I picked up the phone and had the following
conversation:

Dr. Grumpy: "Hello?."

Mr. Fiancé: "Yeah, are you the doctor taking care of my fiancé, Jane Doe?"

Dr. Grumpy: "Yes sir."

Mr. Fiancé: "Are her car keys there? 'Cause it's my car, and I need it back."

Dr. Grumpy: (astounded) "No sir, there aren't any car keys here."

Mr. Fiancé: "Well, did she leave a note saying where the car keys were, or where she left my car parked? I need it, because I have stuff to do today."

Dr. Grumpy: "No, sir, nothing like that"

Mr. Fiancé: "Well, you're no help to me" (hangs up).

One of the best for today. EVER.

Online entertainment

Last night I was signed up to do CME (continuing medical education) with a live webcast.

I don't do these very often, but it was free, I needed the credits, and I figured I could do some paperwork while tuned in. Who knows? I might even learn something.

So the talk began. The speaker was broadcasting from his home office, using a webcam on top of the computer. It seemed like the usual monotonous stuff... "When considering options in the treatment of Frickle-Martin syndrome one must first..."

Then his cell phone rang. "Oh, sorry everyone, I'm on call for my group tonight. I had to switch and tonight was the only... Hello? Yes, this is he. Yes, I rounded on her today. No, the MRI was still being done when I left. I can't talk to her family right now, I'll call back in an hour."

A few minutes later he was reviewing a nail-biting slide on cellular metabolism when he suddenly jumped back in his chair and a large, furry, white Samoyed reared up next to the desk, put it's paws on it, and stared straight into the camera "No! Down Sweater! Bad dog!" Not to be turned away, Sweater licked the speaker's face before disappearing.

A few more minutes went by, when there was a voice in the background. I couldn't hear what it said, but the speaker immediately turned away from a heart-pounding genetics slide and yelled: "I'm busy! I'll look at the math homework later."

Another few slides passed, and a phone rang. He ignored it for 3 rings then answered: "Hello? No, she, went to get Laura from piano class. I'll tell her you called."

The rest of the talk, unfortunately, was uneventful. I finished some office dictations, and made a mental note that if I'm ever asked to a talk like that (nobody is calling, either) I'll probably do it from my office downtown.