Saturday, June 30, 2012

Random Saturday Pictures

First off, we have this sign spotted at a Burger King. Even ignoring the grammar issues, it has to be the most unenthusiatic, uninviting, unappealing ad for a birthday party I've ever seen.

Just makes you want to yell "Sign me up!" huh?



Next is this fine beverage. Because what could be more enticing than a beer whose name translates to "Sudden Death"?

"Preferred 2-to-1 over Kool-Aid."



My reader Leigh recently got her water bill, and was horrified to find her city is spending tax dollars on a talking toilet mascot named "Leaky Loo McFlapper." They're claiming he's "world famous" (hell, I can't even find a FaceBook page for him) though at least he's not artisanal.

"Someday I hope to work up to McD's, when Grimace retires."





And, lastly, there's this technological breakthrough. Because what good is a $300 phone if you can't use it to open a beer?
Opening a beer? There's an app for that.


Friday, June 29, 2012

Care

I'm with a patient when Mary interrupts me. Dr. Intern is on the phone, and says it's urgent.

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

Dr. Intern: "HI! I just ran a Depakote level on Mrs. Seizure, and it's ZERO! I just spoke to her. She hasn't had any seizures, but I told her she needs to get in to see you ASAP!"

Dr. Grumpy: "Hang on... She isn't on Depakote. I changed her seizure meds in 2010, and she hasn't taken it since then. So I'd expect it to be zero."

Dr. Intern: "Why doesn't anyone tell me these things?"

Dr. Grumpy: "Well, it was noted in the letters I sent you. Don't you read them? Or check a medication list at each visit?"

Dr. Intern: "Who has time for that?"

Thursday, June 28, 2012

Gee, thanks

Dr. Grumpy: "What brings you in today, sir?"

Mr. Honest: "Dr. Asshat referred me. He said all the good neurologists couldn't get me in, and so I should see you instead."

Wednesday, June 27, 2012

Mary's desk

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

Mrs. Bekins: "Hi, I need to make an appointment with the doctor."

Mary: "Okay, what's your insurance?"

Mrs. Bekins: "Um... Gee, I really don't know. I'm in the process of relocating to Grumpyville, and don't have a job yet."

Mary: "All right... Would you like to call back when you know more?"

Mrs. Bekins: "No, I still want to set something up."

Mary: "Okay, when are you moving here?"

Mrs. Bekins: "I don't know yet. Could be anywhere from 3 months to a year."

Pause.

Mary: "I think it would be better if you call back when you know when you'll be here."

Mrs. Bekins: "You're probably right. What part of town are you in?"

Mary: "Do you know the areas of Grumpyville?"

Mrs. Bekins: "No. Can you send me a map? And recommend a realtor?"

Tuesday, June 26, 2012

Market share

In medicine there's a mysterious villain called "Big Pharma." This is a secret conglomeration of drug companies working to deprive you of both money and health as part of the New World Order. Depending on how far you buy into this bullshit, doctors are a part of this Medical-Pharma complex, along with (depending on your Haldol dose) any religion you hate, the United Nations, space aliens, homosexuals, and the Dead Milkmen.

Now, obviously, I don't believe this. The one grain of truth in the "Big Pharma" idea is that obviously companies that manufacture something want to sell it. This applies to medicines, car manufacturers, potato peelers, whatever.

Drug companies are required to do research to prove safety and efficacy of their stuff. But they also do smaller studies to try and prove they're at least better than a competitor. These studies, I must admit, tend to favor whoever sponsored them- but keep in mind they're trying to knock down competitors- NOT work with them.

A drug company sponsors a study that showed their drug worked. THE NERVE! Because, after all, no other industry would dare act like this...

So let's look at this article.

Basically (for those of you too lazy to click the link), it's a study that found "stone fruits" (those with large, singular, pits, like peaches) help with obesity and diabetes.

Some out there will claim this shows that Big Pharma is keeping "natural" secrets from them (because you'll otherwise NEVER hear that fruits & vegetables are better for you than a Big Mac). But let's read the disclaimer at the bottom of the article:

"The studies on the health benefits of stone fruit are funded by the California Tree Fruit Agreement, The California Plum Board, the California Grape and Tree Fruit League and the Texas Department of Agriculture."

Here's the bottom line: Everyone will pay for research to sell you their product. Whether it's Big Pharma or Big Farm.


Thank you, SMOD!

Monday, June 25, 2012

That's Amoré!

Mr. Fatherly: "It was really stressful 3 months ago, because my son and his fiancée moved in with me."

Dr. Grumpy: "How are things now?"

Mr. Fatherly: "Better, my son finally moved out last week."

Dr. Grumpy: "What about his fiancée?"

Mr. Fatherly: "I married her. That's why he moved out."

Sunday, June 24, 2012

Wanted: Students with partial amputations

Somehow I think this could have been worded better:


Thank you, Maridyth!

Saturday, June 23, 2012

Friday, June 22, 2012

Notes

Mrs. Flight: "I need a note, saying I'm too sick to travel to New York."

Dr. Grumpy: "Um... but you're not sick at all."

Mrs. Flight: "I know, but I'm trying to get out of this trip, and a note would help."

Dr. Grumpy: "I can't falsify a note for an airline."

Mrs. Flight: "No. It's for my sister. I don't want to go see her because she's a bitch."

Thursday, June 21, 2012

Airborn drug transference

Dr. Grumpy: "I'm going to start you on Coumadin."

Mr. Wisconsin: "But I'm already on it!"

Dr. Grumpy: "You are? I didn't see that in your chart..."

Mr. Wisconsin: "Well, I mean, I'm not on it myself, but my wife takes it. So wouldn't that cover me, too? Just from being near her a lot?"

Wednesday, June 20, 2012

WTF?

I've shown you guys some seriously strange drug company ads over the years.

After 15 years of reading journals I thought I'd seen every weird eye-catching trick an advertising agent can think up.

But, even I was taken aback by the sheer WTFness of a veterinary drug ad my esteemed colleague Webhill sent me yesterday:




 Thank you, Webhill!

Tuesday, June 19, 2012

Decimal fetish

Dr. Grumpy: "Any changes in your weight?"

Mr. Precise: "Yes." whips out iPhone "As of this morning, since January 1, 2012, I've gained 1.5873 pounds."

Monday, June 18, 2012

Saturday night, 11:38 p.m.

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

Miss Hedayk: "Yeah, I see you for migraines, that I, uh, only get during sex..."

Dr. Grumpy: "Yes?"

Miss Hedayk: "Well, I'm over at the Meat Hook bar, and met this really hot guy, and I'm um, out of my migraine pills, and, uh, could you call some into the pharmacy, so I can pick them up on the way to his place?"

Saturday, June 16, 2012

Language

Dr. Grumpy: "It looks like you have high blood pressure?"

Mr. Semantics: "I wouldn't characterize it as such."

Dr. Grumpy: "Okay, but you're on 3 blood pressure medications."

Mr. Semantics: "My internist and I have a difference of opinion of both vital signs and common vernacular."

Friday, June 15, 2012

June 15, 1944


Officer Cynical asked to do a guest post today, in memory of those who gave all in one of the most vicious battles of World War II. Take it away, Officer!

On June 6, 1944 the largest amphibious invasion in history took place in Normandy. Lost in its shadow are equally important events that happened at the same time on the other side of the world.

Today, June 15, 2012, marks the 68th anniversary of the U.S. Marine assault on Saipan.

On June 5, 1944, the same day the allied invasion ships set off across the English Channel for Normandy, another amphibious force left Pearl Harbor to carry out a mission of equal importance in the Pacific. It's almost-forgotten today, but the effects were tremendous. As one Japanese admiral commented, ""Our war was lost with the loss of Saipan."
Saipan was an important objective, both to cut off Japanese supply lines and to provide an airbase from which bombers could reach the Japanese home islands.
At 8:00 a.m., 8,000 Marines came ashore against 31,000 Japanese defenders. Many Marines later stated it was the most savagely opposed amphibious landing of the Pacific war.
Japanese artillery (pre-aimed at the invasion beach), along with machine-gun and sniper fire, made the landing murderous. You can see in the photos below the desperation of the men who have just hit the beach.


Men & machinery coming ashore.



Crawling to duck snipers



The Marines at the center and far left have just been hit by enemy fire.
Many enemy artillary positions were neutralized by gunfire from American warships, which was guided by Navajo code-talkers who'd gone ashore with the troops.
The morning after the landing, the Marines awoke to find every support vessel except a hospital ship had left. The Japanese Imperial Navy had counterattacked the U.S. Task Force near Saipan in an attempt to reinforce and resupply the defenders. The result was the naval/air Battle of the Philippine Sea, and the decisive allied air victory called The Great Marianas Turkey Shoot.
Ultimately, the combined American forces of Marine and Army units numbered about 70,000 men. After three weeks, the Japanese staged a last-ditch banzai charge of about 4,000 soldiers, including their wounded and conscripted civilians. Some had no firearms, but carried sticks with knives tied to the ends and other crude weapons.


Shaking out a shoe, sitting on an unexploded shell from a battleship.
 In the end, 13,790 American (19%) were killed or wounded. 29,000 Japanese (94%) were killed; only 920 prisoners were taken. Some 20,000 of the 25,000 civilians living on Saipan also died, almost all by suicide, either by jumping from cliffs (after throwing their children off) or by blowing themselves up with grenades. They had been convinced by the Japanese military that suicide was preferable to capture by the Americans. 
The nightmare of Saipan shows on the face of this Marine:


The "thousand-yard-stare"

Thursday, June 14, 2012

Hospital rounds

Dr. Grumpy: "What color is my shirt?"

Ms. Haldol: "As black as your greedy, money-grubbing soul you bastard!"

Wednesday, June 13, 2012

Patient quote of the day

"I have a huge pituitary tumor. They told me it was pressing on my sciatic nerve."

Tuesday, June 12, 2012

What SHOULD she do?

Sermo is an online doctor community. Once or twice a week I skim the posts to see if there's anything of interest.

Anyway, one hazard of technology is that a lot of people post while typing on the fly. This, combined with autocorrect, can lead to some eye-catching items.

ADDENDUM: due to lawyers from Sermo sending me threatening email, I had to take the screenshot down (those of you up early saw it). Basically, what it said is:


"One of my colleagues recently had a tubal legation. Now her vagina is demanding an embassy. What should she do?"








Monday, June 11, 2012

Great office moments

Mr. Ataxic: "I've been having a lot of balance problems. My walking is off, and I'm clumsy."

Dr. Grumpy: "Let's go out in the hallway, and let me watch you walk."

Mr. Ataxic goes out in the hallway, and I follow him. Stepping out from behind my desk, I discover (too late) that my shoelace is caught in one of the chair's rollers. As I walk the chair comes with me. I lose my balance and fall, just barely missing Ed. Then the whole chair crashes down on top of me. As the chair flies up it pulls my shoe off and sends it flying under the desk.

Mr. Ataxic: "Yeah, doc, kind of like that, but not as spectacular. Holy shit, are you okay?"

Sunday, June 10, 2012

Weekend reruns

Okay, Grumpyites. My friendly neighborhood Lidoderm (a skin patch for pain after shingles) drug rep left me this.

Drug reps aren't allowed to take us to ball games anymore (I'm okay with that). In fact, this year they've actually been banned from bringing us even cheap pens and post-it notes.

BUT they are still allowed to bring us oddball stuff which falls under "patient education". Like this thing:




What is it? An art deco cactus garden? A model of Bikini Bottom (the home of Spongebob Squarepants)?


Nope. It's a model of the nerve endings of your skin, showing how painful post-shingles pain can be. When you turn it on, notice how the nerves glow red (it's pain, get it)?





And HERE! When you push down on the Lidoderm patch (get it? you're applying it to the skin?) they now glow soothingly blue (ah, that feels better). Thank you, Craig, for the hand cameo.



Isn't this useful! Isn't this revolutionary! Isn't this a great use of your medication money!

The kids and I have now taken out the batteries, and this weekend will study the feasibility of turning it into a new home for Ed, my office fish.

Friday, June 8, 2012

America. Land of really strange crimes.

Some days you think you've seen it all. And then you find out you're wrong.

Thank you, Mark!

Patient quote of the day

"I was on extreme doses of extremely powerful pain medications, because my symptoms were, you know, extreme. My doctor was extremely worried that I'd get extreme side effects, but apparently I have extremely high tolerance. They told me my liver is extremely strong."

Thursday, June 7, 2012

Wednesday afternoon whatever

Mr. Webster: "My mother died of coronary trombones."

Dr. Grumpy: "You mean thrombosis?"

Mr. Webster: "Whatever."

GOALLLLLLLLLLLLLLLLL!!!!!!!!!!!!!!!!!!!!!!!!

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

Ms. Fifa: "I need to make an appointment with Dr. Grumpy right away! When I exercise I get these horrible headaches! They just started last week, and I can't do anything!"

Mary: "Okay, we can see you Thursday afternoon..."

Ms. Fifa: "Oh, I can't come in then. That's when I play soccer."

Tuesday, June 5, 2012

I have a bad feeling about this

Dr. Grumpy: "What medications are you on?"

Mr. Scattered: "I don't know. Whatever my girlfriend puts in my pill cup."

Dr. Grumpy (to girlfriend): "What pills does he get?"

Ms. Girlfriend: "I don't know the names. Whatever his mother tells me to give him."

Dr. Grumpy: "Where can I reach your mom?"

Mr. Scattered: "She's in jail."

Monday, June 4, 2012

My dog tries for the Darwin Award

Due to the weather warming up, I decided to shut down the hot tub for the summer. It's a big round thing, so I drained it and stood it on its side to dry.

Mello saw it standing there, and, to my astonishment, decided it was a giant hamster wheel. So she immediately jumped in it and began running.

This was a disaster in the making.

She actually got it about 20 feet across the yard before the whole thing fell over upside down, trapping her under it.

It was pretty hard not to laugh at the muffled "woof" of astonishment as I went over to free her.

Moron dog.

Sunday, June 3, 2012

Hmmm. Christopher Lee just turned 90...

While doing an online survey about Parkinson's Disease treatments yesterday, I encountered this question about 2/3 of the way through. I can only assume it's to see if I was paying attention:


Saturday, June 2, 2012

Rimshot















Dr. Grumpy: "Where is the pain?"

Mr. Youngman: "In my left buttock."

Dr. Grumpy: "When did it start?"

Mr. Youngman: "When I married Mrs. Youngman."

Friday, June 1, 2012

Annie's desk

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

Mr. Ivac: "Yeah, I need the phone number for the infusion center."

Annie: "We don't have an infusion center at our office."

Mr. Ivac: "I KNOW THAT! I'm talking about the infusion center by Farfaraway Hospital. I need to check on my appointment."

Annie: "Did we refer you there?"

Mr. Ivac: "Hell no! I'm not even your patient! I see Dr. Darth."

Annie: "So why are you calling our office?"

Mr. Ivac: "Because I need the phone number for the infusion suite! Can't you look it up for me?"

Annie: "Okay, but..."

Mr. Ivac: "You people are wasting my time. I'm glad you're not my neurologist." (click)