Biochemistry FAIL

Mr. Biochem: "What did my labs show?"

Dr. Grumpy: "Well, your homocysteine level was high, and..."

Mr. Biochem: "That's impossible! I'm not gay!"

Medical Miracles

I found this impressive quote in another doctor's letter last night:

Ask and ye shall receive

Around Jewish holidays Local Grocery always puts up a display which varies depending on the holiday, featuring Matzoh, or Hanukah candles, or Hamantashen, or whatever is appropriate. They always hang a banner over it that says "The Jewish Experience."

Earlier this week I joked with a friend that if they really wanted to give shoppers "The Jewish Experience" they'd have some old lady there, telling people to stand up straight and making them feel guilty about something.

It was a joke. That was all.

So last night, on the way home, I stopped at the store for apples and a round challah for Rosh Hashanah. I found the "Jewish Experience" display with a pile of challahs, grabbed one... And was blindsided. This ancient silver-haired grandmother pounced on me out of nowhere.

Grandma Crabgrass: "That one's not fresh."

Dr. Grumpy: "Excuse me?"

Grandma Crabgrass: "That challah. It isn't fresh."

Dr. Grumpy: "It feels fresh."

Grandma Crabgrass: "It's not."

Dr. Grumpy: "Fine" (puts down challah A, grabs challah B, starts to turn away)

Grandma Crabgrass: "That one's stale, too. They're all hard as rocks."

Dr. Grumpy: "They're fine. It's not like they're leftover from last year's Rosh Hashanah."

Grandma Crabgrass: "How do you know? Your mother wouldn't approve of that challah."

Dr. Grumpy: "Look. I'm taking this challah and leaving."

Grandma Crabgrass: "You'll need two."


She wasn't even one of my patients.

No kidding

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

Mrs. Morton: "Yes, ether makes me lose consciousness."

Sigh

Look, sir. I think it's great that you want Mom to be able to reach you.

You're obviously a devoted son, and I respect that. In spite of Mom having advanced Alzheimer's disease, you're doing your best to take care of her.

Wanting her to be able to call you at any given time is a noble idea.

BUT

Let's face it. Mom can't work a toaster. So buying her an iPhone was not a great idea.

Great patient moments

"Doctor, I saw something on television last night. They have a machine, called an MRI, that can take pictures of your brain. Have you ever heard of this?"

Schedule

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

Mr. Gregorian: "My previous neurologist retired, so I want to get established with one for this year."

Dr. Grumpy: "Okay. What's up?"

Mr. Gregorian: "I was looking at my calender, and realized that I have heart attacks in even-numbered years and strokes in odd-numbered years. Since it's getting late in 2011 I need to get ready."

Survey

Over lunch I was doing a medical market research survey, and got this question:

"What incidence of injection site reactions would you find acceptable in an oral medication?"

Uh, I guess that would be zero.

Mary's desk, last Friday

(door flies open, really huge wild-eyed guy runs in)

Mary: "Can I help you?"

Really huge wild-eyed guy: "OH MY GOD! IT'S EVERYWHERE! DO YOU HAVE ANY PAPER TOWELS?"

Mary: "Um, sure, back in our kitchen, let me go..."

Really huge wild-eyed guy: "I CAN'T WAIT THAT LONG! NEVER MIND!"

(runs out door)

Crime in America

I guess this trio has redefined "making a clean getaway."

Thank you, William!

Why you need an iPhone

Dr. Grumpy: "Have you ever smoked?"

Mr. Precise: (whips out iPhone, taps a few times): "One cigarette, on September 21, 1958, at around 2:00 in the afternoon. It was when I was at Ohio State."

"I can't stand a wet car, your Honor."

In a world of lame excuses, some people are better at it than others.

Thank you, Alison!

September 23, 1779

Her name was Duc de Duras, and she was a nondescript wooden cargo ship. The French East India Company built her in 1765 for far East trading, and if that had been the extent of her life she'd be long forgotten by now.

For a little over 10 years, she led an uneventful life as a merchant ship, sailing back and forth between France and the Orient. But she was destined for a place in history.

In the late 1770's war was raging between England and her American colonies. King Louis XVI of France was more than happy to join the colonists against his old enemy in Britain. He bought the Duc de Duras, converted her to a warship, and turned her over to the fledgling American navy.

She was renamed, and began her new life as the Bonhomme Richard, under the command of John Paul Jones.

Her story is known to most American schoolchildren. 232 years ago today an American and British squadron met in a remarkably vicious battle off Flamborough Head, England. Although other ships were involved, the main action was between the Bonhomme Richard and the Serapis. Initially the Serapis was winning, and at one point the British asked if Jones had surrendered. His immortal reply was "I have not yet begun to fight!"

On a bloody evening which saw almost half the crews of both ships killed, the Serapis eventually surrendered after a pitched battle and boarding action. The Bonhomme Richard, however, was so badly damaged that she was abandoned, and Jones had to make Serapis* his flagship. The Bonhomme Richard drifted away, sinking sometime the next day.

The Bonhomme Richard, to this day, remains one of the few holy grails of lost ships. As underwater technology has improved more famous ones are found. Titanic. Bismarck. Scharnhorst. Yorktown. Yamato. Ark Royal. Portland. All within the last 25 years.

But the Bonhomme Richard, like the Santa Maria, stubbornly remains hidden. Several well-funded, high-tech expeditions have searched the area where it's thought she sank. They use computers to predict 1779 drift patterns. Side scan sonar to image the seabed. They send down cameras and divers to investigate targets- and still have nothing.

But the answer may have already been found, by an English salvage diver named John Adams.

In Filey Bay, England, there's a mysterious wooden shipwreck. Adams discovered it in 1975 while recovering a fishing net, and year in & out since then has worked to identify it. But poor visibility, a limited diving season, and money have kept the ship a mystery. How it got there also remains unknown, as there's no record of a large wooden ship sinking in the bay.

And yet:

The wreck is a large wooden ship, built in the mid-18th century. Radiocarbon dating of a length of rope gave a likelihood of it being within 10 years of 1767.

The rough design of the wreck matches that used by France for trading ships sailing to the far East.

Worm damage to the hull shows that it spent time in oriental waters- Like the Duc de Duras.

The wreck, although broken into several pieces, is roughly the same total length as the Bonhomme Richard.

The wreck has extensive fire damage. As did the Bonhomme Richard from the battle.

There is no record of a large wooden ship - other than the Bonhomme Richard - sinking in that area.


All the computer models say the Bonhomme Richard drifted out to the North Sea and sank several miles off the coast. And maybe she did, and has yet to be found.

Or maybe the computers are wrong. And the ghost ship in Filey Bay is one of the most famous in history.


*The Americans turned the Serapis over to the French, who used her as a privateer. She was destroyed by an accidental fire in 1781 off Madagascar. Her remains were found by divers in 1999.

Today's mail

There is absolutely NOTHING that can make you feel more inadequate as a parent than an issue of "Working Mom" magazine. It came today, and always has stories like this:

"In this issue we feature Suzy Oveur-Cheever. Suzy spends time at home raising her 2 lovely daughters, is active on her school board, and helps deliver meals to poor families. In addition she's developed a new technique for DNA recombination that led to a breakthrough for cancer and is helping to excavate a 2000 year old shipwreck in the Red Sea. Last week she was confirmed to the U.S. Supreme Court, and will be taking her daughters to Oslo next year to pick up her Nobel Prize after solving the Israeli-Palestinian conflict. In this issue she'll be sharing her recipe for brownies and showing us her homemade Halloween decorations."

Excuses

Mr. Party: "I need a note saying I take Fukitol, and it effects my balance and coordination."

Dr. Grumpy: "But you're not taking Fukitol."

Mr. Party: "I know, but this way I can use it as an excuse if I get pulled over this Saturday."

Life at my desk

Dr. Grumpy: "At your last visit you tried Feelbetter. Has it helped?"

Mrs. Shootme: "No. The first pill made me horribly sick. I had every side effect I read about, so I threw it away."

Dr. Grumpy: "But, according to our records, you had me call a refill into the pharmacy?"

Mrs. Shootme: "I was afraid you'd get angry if you thought I'd stopped it."

Annual Peeve

For the 3rd year in a row I'm going to run this column, as I went to the store last night, and saw it had started already. I'll keep running it until this practice stops. Which likely means the post will be here every damn year until I retire/die/get institutionalized.


Dear Mr. President,

We now face a national crisis of such serious proportions that it dwarfs other issues, such as global warming, health care, and middle-east peace. It now threatens the very fabric of our society, and directly affects every citizen. And I can remain silent no longer.

It's still September, and every store near me ALREADY HAS THEIR CHRISTMAS DECORATIONS UP!

I have nothing against the holidays, Mr. President. Peace on Earth and all that stuff. But moving them up as if they were being held in another time-zone or alternate universe is getting out-of-hand. As far as I know, Christmas hasn't budged in my lifetime. And treating every day like it was Christmas (like the stores seem to want me to do) is not helping.

The well-respected Nick documentary program, The Fairly Oddparents, has carefully researched what would happen if Christmas were held every day (Episode 107, air date 12-12-01 I have kids, OKAY!). Their conclusion? It would be catastrophic.

There also seems to be a degree of unintentional discrimination. For example, Hanukkah starts almost a week before Christmas this year, but I don't see Hanukkah decorations going up 1 week before the Christmas ones. In fact, I haven't seen any at all yet. Or Kwanzaa stuff. Or Festivus. Or New Year's.

This seasonal perversion extends to other holidays, too. I mean, by January 2nd most stores are decked out with Easter junk, and on July 5th the Halloween crap is up.

So, Mr. President, I propose the following, federally mandated solutions (please note: I'm only including those holidays that retailers love. Let's face it, not many of us are out there buying gifts for Groundhog day or cards for Columbus day. I'm also leaving out local holidays like Delaware Statehood Day, the Montana Huckleberry Harvest Celebration, and the Byron, Illinois, Turkey Testicle Festival).

Valentine's Day Decorations will NOT be put up until the 3rd week of January.

St. Patrick's Day Decorations will NOT be put up until after March 1st.

Passover/Easter decorations will NOT be put up until after St. Patrick's day.

Independance day decorations (July 4th) will NOT be put up until the 3rd week of June.

Halloween stuff will NOT be put up before October 1st

Thanksgiving Stuff will NOT be put up before November 1st.

Christmas/New Year/Hanukkah/Kwanzaa/Festivus stuff will NOT be put up until the day after Thanksgiving.

(Please note: there should be some flexibility here, as Hanukkah and Easter/Passover may vary, but decorations should NOT be hung more then 3 weeks prior to holiday onset).


An alternative plan would be to have a single annual holiday combining all of the above, called St. Christmukahpasseastkwanpatfourthnewfestgivingween. Decorations for the combined holidays may be hung for 30 days prior to this event, and MUST be removed the day after.


Punishment for business owners who violate these laws would be on a 3-step basis:

1st offense: Business license revoked for one month.

2nd offense: Tarred, feathered, and forced to eat fruitcake.

3rd offense: Drawn and quartered, then served with fava beans and a nice chianti.


Yours truly,

Ibee Grumpy, M.D.

Show and Tell - not what you remember

Wow. And I thought the seashells I found at the beach were nifty when I brought them in.

Obviously, I wasn't even close.

How is this my fault?

Dr. Grumpy: "Any problems with the new medication?"

Mr. Bond: "Doc, sometimes I just like to have a martini, and the other night, when I really wanted one, I couldn't have one. It's very frustrating."

Dr. Grumpy: (reviews chart) "But James, there's no reason I see here why you couldn't have a martini every now and then."

Mr. Bond: (shakes head) "You don't understand."

Dr. Grumpy: "So what's the problem?"

Mr. Bond: "I was out of olives."

Patient quote of the day

"The pain went down through my legs. Not all my legs, I mean, but just the ones on the bottom of my body."

Sunday night, 11:17 p.m.

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

Mrs. Franklin: "Hi, you see me for nerve damage in my foot, and I'm on Neurontin."

Dr. Grumpy: "Yes. What's up?"

Mrs. Franklin: "Well, lightning struck my apartment complex an hour ago, and started a small fire in the laundry room. The fire department put it out, and everything is okay now."

Dr. Grumpy: "Are you okay? Was your medication lost?"

Mrs. Franklin: "Oh, everything is fine."

Dr. Grumpy: "Why are you calling?"

Mrs. Franklin: "I just figured this is the sort of thing my doctors should know."

Truth, NOT yak shit

The battle against cancer was set back recently, when politicians (not physicians) running for office decided that fear beats hope. False claims were made that the HPV vaccine (which has the potential to cure cervical cancer by preventing it from ever starting) causes mental retardation.

I'd therefore like to post this statement by the president of the American Academy of Pediatrics, Dr. O. Marion Burton. He is not a politician, but is an expert in the care of children.

I hope his statements carry more weight than those of politicians who are more interested in sound bites than truth.

"The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation.

There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.

The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That’s because this is the age at which the vaccine produces the best immune response in the body, and because it’s important to protect girls well before the onset of sexual activity.

In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer."

That's 4000 young women dying each year from an easily preventable disease. One of them could be your daughter - or mine. Marie will get the vaccine next year.

I did not receive any money or gifts to make this statement, nor do I own a financial interest in companies that make these vaccines. I don't know Dr. Burton, either. I'm posting this because, as a yak herder, I know manure when I see it, and believe it should be cleaned up.

Memories...

Like most residents, I moonlighted in various ER's and urgent cares around town.

One night I saw a guy in SERIOUS pain.

He was at Local Grocery, buying a can of soup.

When the pretty teenage girl cashier asked "Anything else you need?" He said "How about this, sweetie?" whipped his winkie out, and laid it on the checkout counter.

The cashier grabbed the soup can and smashed him flat.

The urologist I paged was laughing so hard that he had to hang up and call me back when he'd stopped.

I'll take your word on this one

Mrs. Epistaxis: "Sorry I'm a few minutes late. My mom had a bad nosebleed, and I had to drop her off at the ER."

Dr. Grumpy: "I hope she'll be okay."

Mrs. Epistaxis: "It was a mess. Here's a picture." (whips out iPhone with gory picture).

Dr. Grumpy: "That's okay, I believe you. How have you been?"

Mrs. Epistaxis: "I also have the kitchen towel she was using in my purse here..." (starts digging in purse)

The cup

It's just a coffee cup on our break room shelf.

Coffee cups collect at medical offices, until you have cabinets full of them, far out of proportion to the number of people who work there. Staff bring them in, then forget them. Old employees leave them when they move on. Drug companies used to drop them off.

So as time goes by, coffee cups multiply. After a while the less-used ones get migrated to the top shelf.

This cup sits on the top shelf, at the front. I put it there.

It was brought in by a patient. Not as a gift. He just preferred drinking coffee out of mugs, and didn't like paper cups or plastic/metal containers. So he carried around his own mug, would buy coffee and mix it up in paper cups, then pour it in his mug when he got to his office. Or, in this case, my office. Any place with a stable surface.

I saw him only once, for something minor. He was in his late-30's, married, 2 kids, a business professional. Nice guy. He explained his coffee issue to me as he set his mug on my desk. I thought it was funny, but hell, we all have our own neurosis. We talked about his leg pain, worked out a treatment plan, and agreed to meet back in a month.

The day after he left I found his coffee cup in the exam room. He'd left it behind in a hurry to get out and make it to a meeting on time. I washed it and set it on the top shelf, to give back at his follow-up.

3 weeks later I came in one morning and began leafing through the overnight faxes. One was from the state coroner's office, requesting records. Mr. Cup had died that night of a massive heart attack.

It's been 2 years. When I'm having a bad day, I go look at the cup.

How much do you know about Mom?

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

Mrs. Noclue: "My Mom died of cancer. I think it was prostate cancer."

Death by Magnet

Dear MRI facility,

My reader Jeanette was kind enough to send me the pamphlet you left at her office, showing the advantages of your new, non-claustrophobic, no-tube MRI machine.




I did a highly unscientific poll of claustrophobic patients since then, and all agreed that they'd rather get Valium and do a regular MRI than your "simulated lynching" technique.

But, since I often occasionally sit here and think about strangling my patients, I'll be sure to keep you in mind.

They drive me crazy

Mr. Ophth: "Since the fall I've had trouble seeing. Everything is blurry and out of focus."

Dr. Grumpy: "Did you hit your head?"

Mr. Ophth: "No, but I broke my glasses."

Annie's desk, September 12, 2011

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

Mrs. Clostridium: "Yeah, I was wondering if my Botox for migraines got approved yet."

Annie: "Hang on... No, your insurance denied it. You only have 2 migraine days per month, and it's only covered for patients who have 15 or more migraine days per month."

Mrs. Clostridium: "But I really want Botox. Can he give me something that will make me have more migraines?"

Sunday rounds

I got dragged in to the hospital yesterday for a consult.


Dr. Grumpy: "When did this start?"

Mrs. Stroke: "On Wednesday. I was doing some errands, and suddenly noticed I was dragging my right leg."

Dr. Grumpy: "Why did you wait until today to come to the hospital?"

Mrs. Stroke: "My daughter-in-law's baby shower was yesterday. They don't set themselves up, you know."

Medical news

Since I had to spend yesterday outside at a park, I dragged a pile of dusty old journals with me to do some reading. And I learned that:


Patients who have migraines with nausea are more miserable than patients who have migraines without nausea (though neither group liked having them).

Pain Medicine News, August 2011

The best predictor for improvement in a chronic migraine patient is that they have fewer migraines.

Neurology, February, 2011.



Cancer patients with frequent pain have a lower quality of life than cancer patients with no pain.

Pain Medicine News, April, 2010



People on higher doses of narcotics are more likely to accidentally overdose than people on low-dose narcotics.

Pain Medicine News, April, 2010

Weekend video

Due to a bunch of Boy Scout crud today, I'm just going to post the horrifying "People of Walmart" music video.

In a bizarre twist, I've noticed that after watching it once or twice my brain starts to fill in the words to Billy Joel's "We Didn't Start the Fire", though the People of Walmart music continues.

Patient quote of the day

"I want to find a new GI doctor. I can never get in to see my current one. The only face time I ever had with her was during my colonoscopy."

Spirochetes: Bringing joy wherever they go

This showed up on my fax machine last night:





Because, you know, people always look that happy when told they should be tested for syphilis.

Weenie barbecue

In spite of my daily attempts to keep patients sane (at the expense of myself, Annie, and Mary) bizarre news continues to happen.

Thank you, Katy!

Define "fatal"

Mr. Reaper: "Sorry I had to cancel last month. My mom had a fatal heart attack."

Dr. Grumpy: "I'm sorry."

Mr. Reaper: "It's okay. She's better now, and just started cardiac rehab."

Love and marriage

Dr. Grumpy: "Anything else going on?"

Mr. Discord: "My wife and I are having a lot of conflict. I have these health problems, and she's more concerned with other junk than she is with me."

Lady Discord: "That's not true! I always put you first."

Mr. Discord: "So we're going to counseling..."

(Lady Discord whips out iPhone, starts texting)

Mr. Discord: "What are you doing?"

Lady Discord: "Updating my Facebook status, so my friends know we're at the doctor."

Tonight's forecast: Cold. And not getting any warmer.

As I've said before, this blog is mostly about the insanity of medical practice.

But sometimes things are too weird not to share...

Some of you have written asking way I only post links, rather than the stories themselves. I do this to avoid any sort of copyright issues.

Cartoon characters gone bad

When robbing a convenience store you should wear a disguise.

Some disguises are better than others.

Thank you, LJ!

Unwanted attention

A doctor in my building is retiring, and selling off his practice's stuff.

So yesterday morning he put signs all over the building saying "OFFICE CLOSING! EVERYTHING MUST GO! FURNITURE! OFFICE SUPPLIES! COMPUTER! MEDICAL EQUIPMENT" with his phone number and suite in surprisingly small print at the bottom.

And, on my floor, he put the flier right outside my office.

So all day long Pissy and I's staff were inundated by people coming in to see what we're selling, making us offers on the lobby chairs, asking our staff if they needed new jobs, etc.

And, of course, the way rumors spread I've gotten several calls from other docs who've heard I'm closing up. And panicked patients who are afraid they'll have to find a new neurologist.

One hot set of wheels

There are many alternatives to a car for transportation.

This is not of them.

Thank you, JLG!

Must be a really old model

Patient quote of the day:

Mr. Moore: "I just got a new computer. It has a 1 trilobite hard drive."

Labor Day Holiday, 4:37 p.m.

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

Mr. McGuire: "Yeah, I'm all out of my medicine, and need it called in."

Dr. Grumpy: "Okay, I can do that. What pharmacy do you want it called to?"

Mr. McGuire "Well, I normally use TAP Pharmacy, but they're closed for the holiday."

Dr. Grumpy: "There's a 24 hour Pills-R-Us I can call it to."

Mr.McGuire : "Yeah, but my insurance won't cover me there. Can you call the people at TAP Pharmacy and make them come in and open for me?"

Random pictures

Today is a holiday here in the states (our equivalent of May Day). I understand many countries have parades on May Day. In America we traditionally watch sporting events on television and grill/eat large amounts of beef.

Anyway, since I'm busy fixing the barbecue so Mrs. Grumpy can cook a yak, I'm just putting up pictures my readers have sent.

(click on images to enlarge)


First, a reader in Arizona found this headline in her local online paper. Apparently the Mesa School District is trying to find new teachers. And with good reason:




Next, we have this delicious looking snack for neurologists and zombies:







To prove that the "City of Brotherly Love" is still alive and well, a reader from Philadelphia sent in a note he found on his windshield:






And, finally, for those new parents out there trying to save money, Amazon is selling used diapers:

Sunday reruns

People use different phrases to mean the same thing. Case in point: migraines.

Some patients say "I have migraines". Others say "I get migraines". Occasionally one will use the odd phrase (at least to me) "I take migraines" to mean the same thing (I always want to ask who they're taking them from).

But today I had a lady who used a more, uh interesting, phrase.

When she gets a migraine she has to go lie down in a dark room (which is common). So, for whatever reason, she uses this act to refer to the migraine.

In other words: when she gets a migraine, she calls it "going down".

It is remarkably hard to keep a straight face when the young lady across from me says things like:

"I went down 3 times last week."

"July was awful. I spent the entire month going down".

"I went down on Saturday. I had to do it in front of my kids, too."

And, as she was leaving, she said, "I feel another one coming on. I just know I'll be going down tonight, but have to wait until my husband gets home."

Memories...

In 1997 I was in Boston for a neurology meeting.

One morning I was walking from my hotel to the meeting, and stopped at a Starbucks on the way. After getting my order I sat down by the window to glance through a newspaper.

Suddenly an ambulance, sirens and lights on, came flying down the street outside at warp speed.

It screeeeeched to a stop in the middle of the street. 2 guys got out of the front, walked into the Starbucks, and waited patiently in line. They left the ambulance running in the middle of the street (blocking traffic) with the sirens and lights on.

When they got up to the counter, one used his radio and called the guy in the back with the patient to see what he wanted them to get him.

They got their order, walked back out, squealed the tires, and drove away at warp speed.

I was the only one there who seemed at all surprised.

Mary, bring me a strong drink

Mr. Pill: "I didn't take it. The lady at the drugstore told me it had all kinds of side effects, and that I shouldn't even try it."

Dr. Grumpy: "The pharmacist said that?"

Mr. Pill: "No. It was a lady behind me in the check-out line. She was buying cigarettes."

Wild times

In the past I published an article about a guy who was dating a carwash vacuum cleaner.

And who can forget the touching romance between a man and his patio table?

This week we had a guy elope with a plastic pool raft.

Part of the problem may be that people just seem to keep losing their undies.

This sad problem of keeping your pants on is even affecting the mayor.

Don't we all

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

Mr. Son: "Yeah, both my parents lived until they died."

Definitely not my field

Dr. Grumpy: "Do you have a copy of your most recent labs?"

Mrs. Whiskers: "Yes, here they are" (pulls papers out of purse, hands them to me).

Her lab values were all abnormal, but the normal ranges listed weren't what I'm used to, either. None of them made sense. I was trying to figure this out when I noticed the patient information in the upper corner:

Name: Sparkles
Age: 5 Y, 3 M
Species: Feline

Dr. Grumpy: "Um, I think these are your cat's labs."

Mrs. Whiskers: "Oh, hang on. I have mine here, somewhere..." (starts digging in purse).