Doktur must rite good

This ad was recently posted on a site for freelance writing jobs:

Spelling: it isn't brain surgery. I hope.

Thank you, Donna!

Friday whatever

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

Mr. Lasix: "Yeah, my Dad is a diuretic."

Dr. Grumpy: "You mean diabetic?"

Mr. Lasix: "Whatever."

Damn, you caught us

Dr. Grumpy: "It looks like the hematologist wants to do a bone marrow biopsy to find out..."

Mr. Gammopathy: "I'm not doing that bullshit."

Dr. Grumpy: "May I ask why?"

Mr. Gammopathy: "I know the games you people play. What you really do is inject my healthy marrow with lymphoma cells, thereby tying me into the medical-military-industrial complex that the government is running."

Post-Christmas rerun

In 2008, the following message was left on my office voicemail around 8:30 p.m. Christmas Eve:

"Hello, I'm calling from Local Pharmacy about a refill for Dr. Grumpy. It's on patient Amy Loid, for her medication. The idiots at her nursing home didn't realize she was all out until 5 minutes ago, and then were stupid enough to think they could just waltz down here and get more. But no, there were no refills.

"So if someone could please call me to refill this, this bunch of bozos at the care home want it tonight. And I'll be here, tonight, on Christmas Eve, at Local Pharmacy, all damn night. So you can reach me whenever you call. My name is Joy. Thank you."

Merry Christmas to all!

Weekend on call

Dr. Grumpy: "So you haven't been taking your seizure medication at all?"

Mr. Stoner: "I don't need to! See, my friend gives me marijuana, and if I smoke it several times a day than I don't have seizures. Hey, can you give me some while I'm here? He's not answering his phone."

Dr. Grumpy: "Local Hospital doesn't keep marijuana in the pharmacy and..."

Mr. Stoner: "Well, I'm not going to take any of your pills!"


Several hours later, at the nursing station...


Dr. Grumpy: "All right, here's some orders on the new admission. Hey, has Mr. Stoner had his EEG yet?"

Nurse: "He left AMA*. Didn't anyone tell you?"

Dr. Grumpy: "No. When did this happen?"

Nurse: "After you told him the hospital wasn't going to give him marijuana. He snuck out of his room and went down to ER, trying to find a patient there who could sell him some. When security came after him he ran out of the building and didn't come back."


*Against Medical Advice, for the non-medical readers. Basically walking out.

Skool Nerse Page

This is Mrs. Grumpy, announcing that I now have my own page on the site, compiled from my posts.

You can find it down in the right sidebar, or click here.

Guest post from Officer Cynical

While the insanity of our world takes over headlines, the legacy of one man has been largely ignored. Daniel Inouye died on Monday, December 17th.

Inouye served as congressman and senator from Hawaii since the date of its statehood in 1959 until his death. He was also a Medal of Honor winner during WWII. The following is the citation for that award:  

________________________________________

The President of the United States of America, authorized by Act of Congress, March 3, 1863, has awarded in the name of The Congress the Medal of Honor to

SECOND LIEUTENANT DANIEL K. INOUYE
UNITED STATES ARMY

for conspicuous gallantry and intrepidity at the risk of his life above and beyond the call of duty:

Second Lieutenant Daniel K. Inouye distinguished himself by extraordinary heroism in action on 21 April 1945, in the vicinity of San Terenzo, Italy. While attacking a defended ridge guarding an important road junction, Second Lieutenant Inouye skillfully directed his platoon through a hail of automatic weapon and small arms fire, in a swift enveloping movement that resulted in the capture of an artillery and mortar post and brought his men to within 40 yards of the hostile force. Emplaced in bunkers and rock formations, the enemy halted the advance with crossfire from three machine guns. With complete disregard for his personal safety, Second Lieutenant Inouye crawled up the treacherous slope to within five yards of the nearest machine gun and hurled two grenades, destroying the emplacement. Before the enemy could retaliate, he stood up and neutralized a second machine gun nest. Although wounded by a sniper's bullet, he continued to engage other hostile positions at close range until an exploding grenade shattered his right arm. Despite the intense pain, he refused evacuation and continued to direct his platoon until enemy resistance was broken and his men were again deployed in defensive positions. In the attack, 25 enemy soldiers were killed and eight others captured. By his gallant, aggressive tactics and by his indomitable leadership, Second Lieutenant Inouye enabled his platoon to advance through formidable resistance, and was instrumental in the capture of the ridge. Second Lieutenant Inouye's extraordinary heroism and devotion to duty are in keeping with the highest traditions of military service and reflect great credit on him, his unit, and the United States Army. 

______________________________________________________

More remarkable (to me) is Inouye's own description of those events. The Atlantic published the following - Inouye's personal account of his Medal of Honor-winning actions in the town of San Terenzo, Italy, in 1945.

Inouye's unit was charging three German machine guns.

'"I remember being shot in my abdomen, first, on the right side. The bullet came out in the middle of my back, and it felt like someone had slugged me. There was no intense pain or anything like that. I fell backwards and then kept on going until my messenger right in the back of me ... said, 'By the way, you're bleeding.' So I stuck my hand in there and, sure enough, it was warm and moist. I took out my hand. It was all bloody but, since it wasn't bleeding profusely, I just kept on going."

Continuing forward with a bag of grenades, he cocked his hand and was ready to throw another when a German grenade hit him in the arm, leaving his right arm dangling by a thread.

'"I saw a fellow pointing it at me and I felt the blast and I recall going for my grenade, prying it out of my right hand and throwing it with my left. My arm was dangling by a couple shreds, so when I lifted it up, it was hanging like that. Just shredded. So I knew it was gone. First I was looking all over for the grenade, I thought it fell. And then I looked at my hand and I said, 'Oh, my Lord. It's there.' I had pulled the pin, and my hand was back ready to toss it, so I knew it was armed. The fingers somehow froze over the grenade, so I had to pry it out."

With his left hand, Inouye tossed the grenade at the German who had shot him, hitting him. Then he blacked out. Later, when he was cited for his bravery, he learned that he had grabbed a tommy gun in his left hand, charged toward one of the machine guns, knocked it out, and then got shot again. He was given so much morphine that doctors later amputated his arm without anesthetic, concerned that any more would drive his blood pressure too low."

 ________________________________

I try to remember that, while a few nutjobs are out killing kids and cops and firefighters, real heroes walk among us.

Today's featured gift #1

Today wraps up the 2012 Grumpy gift guide, with the following 2 items. I hope you've enjoyed it! If you see anything out there that catches your eye, please send it in and I'll consider it for next year.


 This gadget is advertised for training dogs.

Looking at it I can't help but think that if someone tied a rope around my, uh, boy parts down there, I'd be pretty "calm and orderly," too.

Today's featured gift #2

Now this one I kind of like. Because a leading problem of the modern workplace is the dreaded lunchroom thief. This drove Mrs. Grumpy nuts, as no matter how brightly she wrote her name on an item, it would still disappear before she had a chance to touch it.

But now, you can get this awesome lunchbox:

This great lunchbox is just perfect for any workplace, or the ax murderer on your list. Mary and I use hers to hide body parts after I've finally snapped at a patient on their 5th consecutive visit who hasn't yet started the medication I prescribed, but is still complaining that they aren't any better.

Mary's desk, December 19, 2012

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

Mrs. Dilly: "Yeah, I have an appointment in an hour, and I'm going to have to cancel it. I'm in the Emergency Room."

Mary: "Are you okay?"

Mrs. Dilly: "Yeah, I was all blocked up down there. I think I ate too much cheese."

Mary: "I'm sorry. Just call us back whenever..."

Mrs. Dilly: "They just gave me my third enema. I've never seen so much shit in my life. Do you have anything open on Friday afternoon?"

Skool Nerse time

Attention parents:

Calling in to say your kids will be absent on Thursday and Friday, because it's the end of the world, is absolutely the lamest excuse for a long weekend I've ever heard.

If you really believe that, you're going to have a boatload of catch-up Christmas shopping to do this weekend.

Gee, why didn't I think of that?

Joe: "Local Hospital computer help, this is Joe."

Dr. Grumpy: "Hi, I went to read an EEG, and the reading room is, um, gone. I mean, completely vanished, and they're building an orthopedic supply closet where it used to be."

Joe: "Is this a problem?"

Dr. Grumpy: "Well, yeah. A lot depends on my ability to read EEG's on the hospital patients. If I don't have the results, then I can't make treatment decisions."

Joe: "Look, we spent a lot of time setting things up so you guys can read EEG's from home, WHICH YOU ASKED FOR, so why can't you just drive home, read them, then come back and round?"

Today's featured gift

Do you enjoy mini-golf? Do you love bathroom humor? Have you ever wanted to show the office golf asshat where he can put his ball? Then this is ideal for you!

Yes, with this remarkably tasteless gadget, you can pretend to whack a golf ball into someone's ass and listen to them fart. You can repeat this action until the joke is old (1-2 times) and then give it to that co-worker you hate in the office gift exchange.

Proud parenting moments

At my parent's 50th anniversary party, which was held at an incredibly swanky restaurant:

Grandma Grumpy: "Marie, are you enjoying your dinner?"

Marie: "Yes. I like this place. It's fancy. It doesn't have gum under the tables."

From the "No shit, Sherlock" research department

The mere anticipation of an interaction with a woman can impair men's cognitive performance.

Archives of sexual behavior, (2012) 41:1051-1056 

Abstract

Recent research suggests that heterosexual men's (but not heterosexual women's) cognitive performance is impaired after an interaction with someone of the opposite sex (Karremans et al., 2009). These findings have been interpreted in terms of the cognitive costs of trying to make a good impression during the interaction. In everyday life, people frequently engage in pseudo-interactions with women (e.g., through the phone or the internet) or anticipate interacting with a woman later on. The goal of the present research was to investigate if men's cognitive performance decreased in these types of situations, in which men have little to no opportunity to impress her and, moreover, have little to no information about the mate value of their interaction partner. Two studies demonstrated that men's (but not women's) cognitive performance declined if they were led to believe that they interacted with a woman via a computer (Study 1) or even if they merely anticipated an interaction with a woman (Study 2). Together, these results suggest that an actual interaction is not a necessary prerequisite for the cognitive impairment effect to occur. Moreover, these effects occur even if men do not get information about the woman's attractiveness. This latter finding is discussed in terms of error management theory


Thank you, Vince!

Today's featured gift

Before moving on to the post, I'd like to say something:


HAPPY 50th ANNIVERSARY MOM AND DAD!

And now back to our regular program.

 
Is your favorite cook tired of drab colors? Do they want to spice things up? Well, you should give them Esslack: edible spray paint for food!

Think of the possibilities: gold chicken, blue steak, or fire-red asparagus! Make your holiday dinner look like something out of Willy Wonka (the 1971 version).

Foodies in the 'hood can give up using plain, inedible Krylon and do some serious food tagging to let everyone know that particular Big Mac is YOURS.

Your kids already believe you're trying to poison them. So why not have fun with it?

Today

I want to offer my thoughts, prayers, and condolences to all affected by the terrible events of today.

Today's featured gift

Have a friend who likes tasteless historical knick-knacks? Consider this:

Now they can own a bobblehead doll of the man who murdered America's 16th, and probably greatest, President. Ideal for those who enjoy, um, I guess, this sort of thing.

As best I can determine bobbleheads of Lee Harvey Oswald, Charles Guiteau, and Leon Czolgosz are not currently available.

Wednesday night, 7:45 p.m.

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

Mrs. Down: "Hi, are you covering for Dr. Nerve?"

Dr. Grumpy: "Yes, what can I do for you?"

Mrs. Down: "I'm emotionally uncomfortable."

Dr. Grumpy: "About what?"

Mrs. Down: "I'm worried I may run out of gas on the way to the drugstore."

Mary's desk, December 11, 2012

Wild-eyed guy breathing rapidly throws open the door, runs in, stands at counter.

Guy: "HEY! CAN YOU GUYS BREAK A $100 BILL?!!!"

Mary: "Uh, no, sorry. We only have a few $5's and $1's for change."

Guy: "SHIT!"

(runs out, door slams behind him)

Today's featured gift

Have a friend who REALLY loves Christmas music?

Yes, now even in private moments you can enjoy the gentle melodies of holiday tunes, and imagine you're being bombarded with them in Wall-to-Wall-Mart. The more TP you use, the more it plays. So even if you're having explosive diarrhea you'll never run out of musical entertainment (as long as you don't run out of paper or batteries).

At present it is not available in Hanukkah/Kwanzaa/Festivus forms, or with music that can be played year round (such as the Mama's & Papa's "Go Where You Wanna Go").

$5

Recently there was a news story about Dr. Russell Dohner, of Illinois. He charges all patients a flat fee of $5/visit. He doesn't take insurance.

This led to several online threads featuring comments such as "Finally! A doctor who cares!"

Apparently, this means that doctors like me, who charge more than practically nothing, are evil and don't care.

I respect Dr. Dohner, and am not putting him down. I think highly of what he does. I actually like what I do, and if I were independently wealthy and could see patients for free, I probably would.

It isn't until almost the end that the article notes Dr. Dohner is supported by his family's farming business, and NOT his medical practice. By that time most readers have moved on to the football scores and "Dancing with the Stars" results, and therefore are left with the impression that any doctor can do this for $5 a head.

Bullshit.

I do care.

But that doesn't mean I don't have my own responsibilities: like office rent. And paying Annie & Mary. And a mortgage. A wife. 3 kids. If I can't support those things, then I'm not going to be able to keep my office open to care for people.

Regardless of what people may think, just because I charge for my services doesn't mean I don't care.

I care enough to call in your seizure medication to a pharmacy at 2:00 a.m. because you're out of pills, even though you knew you needed a refill for at least a week.

I care enough to call you from my family vacation to go over your MRI results, because I didn't think they should wait until I got home, or that you should get bad news from a covering doctor who doesn't know you.

I care enough to come in early and see you at 7:00 a.m. because you can't get time off work, but really do need to be seen.

I care enough to spend time arguing with some pinhead at your insurance company about why you need an MRI, when they don't think you do.

I care enough to rush in to the hospital to see you on my weekend off, rather than let a hospitalist who doesn't know you from Adam try to figure this out.

I care enough to call a drug rep and beg for samples of your medication because you lost your job and can't afford it.

I care enough not to order unnecessary EMG's and EEG's on you, even though doing them would improve my revenue.

I care enough to face worsening reimbursements and rising expenses every day, when many colleagues have given up and gone into another field.

I care enough to try and give you hope, even when I'm not sure there is any.

I care enough to help you find another neurologist who will take good care of you, because your crappy insurance won't let you see me anymore.

I care enough to step out of my kid's music recital and take your call, because I know you're scared.

I care enough to take the time and explain why the drug you saw advertised on TV isn't a good idea in your case, rather than just writing a script to shut you up.

I care enough to stay in a job that has deprived me a of decent night's sleep, family time, and likely shortened my overall lifespan, in spite of the fact that my financial goal nowadays is just to break even.

I care enough to refer you to a neurological subspecialist who can take better care of you than I can, even though in doing so I'll lose you as a patient.

I care enough to call your spouse at 9:00 p.m. to reassure them that you'll be all right.

I care enough not to force you to have a test you can't afford, even though you can sue me for malpractice if I miss something.

I care enough not to dismiss you from my practice, in spite of your insanely annoying personality, because I know that you really do need my help.

I care enough to still be doing this job, even though every day a little bit of my idealism dies.

I care enough to be a doctor. I hope I always will.

It's time!

Amazon weirdness

Today's featured gift

Picnics are SUCH a hassle. You have to sit on the ground, and balance a plate, and eat- ALL AT THE SAME TIME. Let's face it, unless you're remarkably dexterous, you'll starve. Or make a mess. Or both.

But now, there's Picnic Pants!

Now you can attend picnics unafraid of spillage or being unable to find a table! You walk around with what looks like a large gray scrotum, or crotch-cape, or whatever, secure in the knowledge that merely by sitting cross-legged you'll have a convenient place to set your lunch.

History rerun: December 6, 1917

It was World War I.

Gigantic convoys of ships carrying weapons, food, and troops went constantly to Europe, bringing supplies to the Allies. They left from several major Canadian and American ports.

On this day one of them went horribly wrong. And outside of where it happened, it's mostly forgotten.

A large convoy was gathering in Halifax harbor for the trans-Atlantic journey. One ship was a freighter heavily loaded with explosives, the S.S. Mont-Blanc.

At 8:40 that morning, due to a series of mutual errors, she collided with the freighter S.S. Imo.

The Mont-Blanc immediately caught fire. Her crew tried to put it out, but due to its rapid spread were unable to. Scuttling attempts were unsuccessful, and the crew were forced to abandon ship. Someone rang a fire alarm, and several firefighting teams quickly responded to the docks. But with the ship in the harbor, there was little they could to but watch it burn. None of them knew about its cargo.

At 9:04 a.m. the disaster happened.

The ammunition cargo on the Mont-Blanc exploded with the force of 3 kilotons of TNT (roughly 1/5 the strength of the Hiroshima atomic bomb). To this day it remains the largest accidental explosion in human history, and until the 1945 nuclear tests was the biggest man-made explosion ever. Windows were shattered 10 miles away. Objects fell from shelves 80 miles away. The explosion was heard over 200 miles away.

A mushroom cloud and fireball rose over a mile into the air, and a tsunami wave of water, 60 feet high, was sent surging into Halifax. The steamship Imo was picked up and thrown ashore like a toy. Many people (including the firemen) who'd gathered ashore to watch, or were trying to get to the Mont-Blanc to help, simply vanished.

Fire spread through the city. Since it was winter, many homes had furnaces and heating stoves alight, and the shock wave blew them over, spreading heating oil and coal on the ground. Red hot shards of the ship's metal rained everywhere in the city, starting fires in buildings not directly affected by the explosion. A half-ton section of the Mont-Blanc's anchor was thrown over 2 miles into the city, and is now part of a monument. To this day St. Paul's Church has a piece of wreckage embedded in the building.

The city within 1 mile of the entire explosion (326 acres) was utterly destroyed. Buildings, docks, warehouses, homes, and people- all gone in a few seconds. Large fires swept quickly through many city blocks, fueled by winter stores of coal and heating oil. An inferno grew quickly.

Many of Halifax's rescue workers were injured or killed by the explosion, and so the city's ability to react was already impaired. Firefighters from nearby communities came to help- only to find that fire hose and nozzle sizes weren't standardized, and they couldn't connect to the Halifax hydrants. In spite of this, they and surviving local crews worked valiantly to put out the fires, and began rescue efforts of the many trapped under collapsed buildings.

But it was a northern Winter, and darkness came early, along with bitter cold. Rescue workers struggled through the night, chasing voices and moving frozen debris by hand.

The dawn brought light- and a heavy snowstorm. It became the largest blizzard of that decade, dropping 16 inches of snow in a few hours. It put out the last of the fires, but also impaired efforts to reach those who were trapped. Many survivors stuck under debris died from exposure while awaiting rescue.

This view overlooking Halifax harbor was taken after the snowstorm. This had previously been a busy neighborhood and business district.

All told, roughly 2,000 people died- 600 of them under 15 years of age. Another 6,000 were seriously injured, with 9,000 total wounded. 31,000 more were either homeless or had only minimal shelter. Many of the wounded were blinded by flying glass, and care for them eventually led to new treatments for eye trauma.

Although there were many heroes that awful day, one man stands out. His name was Vince Coleman, and he was a railway dispatcher ashore. When he learned of the burning ammunition ship, he realized that a loaded passenger train would be at the waterfront depot in a few minutes. Instead of saving himself, he ran to the telegraph key and quickly tapped out "Stop trains. Munitions ship on fire. Approaching Pier 6. Goodbye." He was killed a few seconds later in the explosion, and is credited with saving at least 300 lives.

Local hospitals overflowed with the dying and wounded, and anyone with medical training was pressed into work. The overtaxed Canadians were assisted by medical crews from American and British warships that had gathered for the convoy. An old ocean liner was turned into a hospital ship overnight. Other medical responders arrived, sent from all over Nova Scotia to assist.

Word of the disaster reached America in a few hours, and the state of Massachusetts rapidly organized a relief effort. All available trains in Boston were frantically loaded with food, medical supplies, shelter materials, and volunteer rescuers and medical personnel. The first train left Boston the night of the explosion, chugging through the same blizzard that was impairing relief efforts, and arriving roughly 30 hours later. It was followed by many other trains from all over Eastern Canada and America. The supplies and workers they brought are credited with keeping the death toll from going higher.

It's been 95 years since the tragedy, and the American assistance hasn't been forgotten. To this day Nova Scotia annually chooses it's finest Christmas tree and sends it as a gift to the city of Boston. This is the tree that stands in Boston Common every holiday season, remembering assistance in a time of need.

Modern English

The introduction of a medical letter is important. It sets down basic patient data and gives you an idea of their chief complaint. When you screw something that simple up, you just know it's going downhill from there:

I get all kinds of letters from other doctors. Most are understandable (although the computer template ones often give me no clue what they're thinking, if they're thinking at all).

I get some, however, that are full of garbled phrases. I have no idea if this is due to bad language skills, lack of good transcription (yes, Dragonphiles, YOU!), crappy proofreading, or all of the above.


Here we have this sentence (from another neurologist no less) which defies all structural rules of the English language:




Or this:




You see all kinds of odd stuff:

 Some of which makes no sense whatsoever:

At times the salutation at the top isn't particularly flattering:

Lastly we have this doctor, who's apparently so embarrassed by his shitty notes that his name isn't even on them:


 

Thanks to all who sent these in!

Mary, call tomorrow's 3:30 and cancel him

A packet of records showed up on a new patient who has a pending appointment with me. It included this note from his previous neurologist:

"He's quite insistent on being allowed to get his drivers license back. When I refused to comply, he pulled out a gun and threatened me with it. Fortunately, his wife quickly took it from him and told me it wasn't loaded."

Weekend reruns: What does a neurologist do?

Every day a neurologist has to deal with many serious medical questions. Annie and I constantly exchange email concerning critical patient problems and other important issues.

Here, for example, is a conversation excerpt on a patient who called in for urgent medical advice.

Yes, I know

Dr. Grumpy: "Have you ever been a smoker?"

Mr. Vague: "No. I mean, not that I know of. But you never know. You know?"

Call out the instigator, because...

Guy walks in, stands at front counter.

Guy: "I have an appointment with Dr. Grumpy."

Mary: "Hello. Since you're a new patient, I'll need you to fill out this form... Here's a pen..."

Guy: "Oh my God! Can you smell the mold in here?!!!"

Mary: "Excuse me?"

Guy: "It's horrible! It's overpowering! How can you can work in here?" (whips out handkerchief, covers nose and mouth)

Mary: "I'm sorry, I don't notice anything... I'll also need a copy of your insurance card."

Guy: (talking through handkerchief) "You must be used to it. I'm amazed you haven't died. I don't want to fill out the forms, I'm sure the pen and clipboard are covered with mold. In fact, I can see it. Can you fill them out for me? You may be immune to it."

Mary: "Okay... but I'll need a minute. First I have to copy your card, and answer that call, and check out the person the doctor just finished with, and..."

Guy: "You want to do all that crap?  I could die at any minute from all the mold in your filthy building! I bet it's never even been tested. I can't sit in here and wait to see your doctor! This building is a death trap."

Walks out.

Dr. Grumpy's Gift Guide, 2012!

Yes, with the clock ticking down toward one of the most important birthdays in human history (Sir Isaac Newton, born December 25, 1642) it's time for...

(D-R-U-M-R-O-L-L))

Dr. Grumpy's annual holiday gift guide!

For those of you interested in fine merchandise featured in the past, please click here 


I'm going to start things off this year with a gift that solves a common argument in modern households:


Him: "We need a new alarm clock."

Her: "I need a new vibrator."


Well, now you can have BOTH! The Little Rooster is an alarm clock AND a vibrator!

Yes, ladies, with this remarkable product you just set the time you want to wake up, put it in your panties, and go to bed (I suppose guys can use it, too, but the sensation isn't the same).

It has 2 motors with 30 different power levels (of which 27 are "silent"- though I don't know if  that applies to the gadget, its user, or both) and features a "snorgasm" switch (I SWEAR!) for when you want to go back to sleep.

If you wake up at night wondering what time it is, no need to look at the nightstand: Now you can simply check your crotch!

The site notes it can also be used as a regular alarm clock "for when you simply have to wake up feeling grumpy." I'll let Mrs. Grumpy know.

It's available for $99 in both pink and white, has a "travel lock,"  and comes with a USB charging cable.

The website says "There is nothing else on Earth like Little Rooster." I'd have to agree with them.

My brain hurts

Dr. Grumpy: "Any other issues we didn't talk about?"

Mr. Huh: "No, I think you've covered everything you have, and you haven't covered anything you shouldn't, and everything that you didn't cover wasn't mentioned. So, I think we haven't talked about anything that wasn't discussed."

Doctors behaving badly

I'm with a patient, when Mary appears in the doorway.

Mary: "Excuse me, but there's a Dr. Fuchs on the phone. He says he's a radiologist, and needs to speak with you urgently."

Dr. Grumpy: "Okay" (looks at patient and starts to pick up phone) "Excuse me for a sec... Hello, this is Ibee Grumpy."

Dr. Fuchs: "Hi, this is Roy Fuchs, I'm a radiologist in north Grumpyville."

Dr. Grumpy: "What can I do for you? Is one of my patients at your place?"

Dr. Fuchs: "Not yet, but that's why I'm calling you. My brother Luke, who's also a radiologist, and I just bought a used MRI and have set up our own imaging facility. I was wondering if I could come by your office in a few minutes to give you some info about it."

Dr. Grumpy: "I'm booked up with patients today, and..."

Dr. Fuchs: "I'm sure they won't mind waiting a little longer, knowing that your time hearing about our MRI is in their best interests."

Dr. Grumpy: "Wait... but you told my staff you needed to talk to me urgently?"

Dr. Fuchs: "Well, I'm on my way to your area, and thought you'd want to know about our facility before you order any more studies. So what do you say? Can I get you something from Starbucks?"

Dr. Grumpy: "Don't bother." (hangs up) "I'm terribly sorry, Mrs. Patient, now back to your medications..."

November 23, 1983

On this day in 1983... A man died.

Okay, so I'm sure a lot of people left us on November 23rd, 1983. But this man deserves to be commemorated. Not for how he lived, but how he died.

James "Jimmy the Beard" Ferrozzo was 40 years old, but had a tough reputation from working in the strip clubs of San Francisco's North Beach area. At the time of his death he was the assistant manager of The Condor Club, which remains in operation today.

The Condor was America's first topless club, and was made famous by Carol Doda. She was among the first topless dancers (and definitely the first bottomless) in the area, and unquestionably one of the most famous strippers ever. She built the reputation of the club (which hosted several visiting dignitaries during the 1964 Republican convention), and for many years The Condor's sign featured a full length picture of her with flashing red lights on her silicone-enhanced size 44 chest.

Her act began in dramatic fashion. She'd enter the theater from above, lying on a white, velvet-covered baby grand piano. It slowly descended from the ceiling and moved to the stage, where she took it off- all off.

Back to my story:

We don't know exactly what happened on that fateful night 29 years ago, between The Condor Club's closing time and when a janitor came to clean up in the morning.

James Ferrozzo was dating a 23 year old stripper named Teresa Hill. Sometime after the club closed the 2 of them climbed on top of the piano, I assume to make sure it was tuned. They apparently hadn't started, as his body was fully clothed when found (she wasn't wearing quite as much).

Somehow, likely due to their legs hitting the switch, the piano turned on, and began rising toward the ceiling. Distracted with other activities, neither Mr. Ferrozzo nor Miss Hill noticed the slow change in altitude.

When the janitor arrived at 7:00 that morning, he heard Mrs. Hill screaming and called the San Francisco police and fire department.

James Ferrozzo was dead, crushed against the ceiling, and was still on top of Miss Hill, who was lying on the piano.

Miss Hill was alive, but trapped. Attempts to lower the piano were unsuccessful, as its motor had burned out during the night. The fire department had to destroy it in order to free the young lady. She was taken to a local hospital, and treated for bruises.

Due to intoxication, Miss Hill had no recollection of the evening's events, or even of getting on the piano at all. She remembered having been in the club that night, and then waking up pinned between the late Mr. Ferrozzo and the piano.

Mr. Ferrozzo was determined to have died of asphyxiation from being crushed between the club's ceiling, a nude dancer, and a moving velvet-covered piano. His large frame (6'2", 220 lbs.) is likely what saved Miss Hill's life, as it provided several inches of cushioning between her and the roof.

Today Carol Doda runs a lingerie shop in San Francisco, and still performs as a singer/dancer (with her clothes on) at local restaurants.

Teresa Hill vanished into anonymity, and likely lives in modern suburbia. She's probably grateful not to remember much of the night, and may not own a piano.

The Condor Club is still in business, albeit after some ownership changes. The drink menu now includes a concoction named "Sex on the Piano" in Mr. Ferrozzo's memory.

Thanksgiving Thursday morning

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

Mr. Turkey: "Yeah! Are you guys open on Friday?"

Dr. Grumpy: "No, we're not."

Mr. Turkey: "Crap. I need to get my prescription refilled."

Dr. Grumpy: "Okay, I can call it in. Which pharmacy do you use?"

Mr. Turkey: "I don't need it until Monday, so I'll just call back then. Thanks!"

Tuesday morning

Dr. Heller: "This is Dr. Heller, with Major Illness Insurance."

Dr. Grumpy: "Hi, this is Ibee Grumpy, I'm a neurologist, trying to get a brain MRI authorized on one of my patients."

Dr. Heller: "Okay, can you tell me about her?"

Dr. Grumpy: "She had a brain MRI on May 21, 2012, which showed a possible mass, so this is a 6 month follow-up study to see if it's changed."

Dr. Heller: "Okay... That sounds reasonable, but it hasn't been 6 months yet."

Dr. Grumpy: "What?"

Dr. Heller: "Well, her previous study was done on May 21th. Today is November 20th. So it isn't 6 months yet."

Dr. Grumpy: "Well, the study won't be done until next week, anyway, when it will have been 6 months."

Dr. Heller: "But the point is that you're calling on the 20th. It won't be 6 months until tomorrow."

Dr. Grumpy: "So you can't authorize this?"

Dr. Heller: "Nope. You'll have to call back tomorrow. Have a good day."

Medical education

I'd like to thank my friends at VBB, who sent me this illustration seen in a Urologist's office:

It raises a number of points (so to speak):

1. Wow. I had no idea urology models were this buff. Usually the patients are guys in their 70's with a bloated prostate.

2. Where's the left adrenal gland?

3. What's with the hands? They look like a 1970's GI Joe doll.

I asked my staff for opinions, and they feel our office needs more educational displays of this sort.

Microbiology

Last Friday Frank had a cold, and got sent home from school. My office is near Wingnut Elementary, so during a break in the action I picked him up and put him in the back office with stuff to keep him busy.

Since he had a low grade fever I got some Tylenol out of my desk and had him take it. I asked if he needed a Diet Coke to wash it down, but he said no. He pulled a store bottle of chocolate milk out of his backpack and drank most of it while swallowing them.

Dr. Grumpy: "Did mom buy you that this morning?"

Frank: "No, I traded Matt for it at lunch last week."

Dr. Grumpy: "LAST WEEK?"

Frank: "Don't worry. It's been in my backpack the whole time, and almost always inside."

Weekend entertainment

Due to an insane amount of kid stuff this weekend, I'm just going to share one of history's finest movie moments.

Thursday afternoon

Mrs. Patient: "I think my mother, Lucy, saw you several years ago."

Dr. Grumpy: "She may have. What's her last name?"

Mrs. Patient: "I don't know anymore. She changes it all the damn time."

Found in a hospital chart

I don't know what it is. But it sure sounds bad.

For non-medical readers: The real phrase is "subarachnoid hemorrhage," which is a bleed in the spaces around the brain.

History in 1:37

All shook up

My cell phone rings while I'm with a patient. It's one of my call partners office.


Dr. Grumpy: "Hello? This is Dr. Grumpy."

Voice: "Please hold for Dr. Nerve." (This drives me nuts. WTF can't other doctors dial a damn phone?)

Dr. Nerve: "Hello? Ibee?"

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

Dr. Nerve: "Can you trade call with me for this weekend? I just found out that my (soft voice) mumble whisper gargle is in town."

Dr. Grumpy: "That should be okay. What did you say was happening?"

Dr. Nerve: "My (whispers) mmph chz fumph is in town."

Dr. Grumpy: "I still can't hear you."

Dr. Nerve: "Hang on, let me close my office door so my staff can't hear me... I said my favorite Elvis impersonator is in town."

Probably bothers bystanders, too

Dr. Grumpy: "How are you doing with the new medication?"

Mr. Firearm: "Fine. The tremor is much better. Now it only bothers me when I'm shooting a handgun."

Veteran's Day

Veteran's day is to thank those who have served the militaries of our respective countries. We throw parades, hold services, and honor our warriors in many ways. But it should never be forgotten that not all veterans walk upright.

Sergeant Stubby, United States Army

No one knew when or where he was born. In common terms he was just a stray dog.

It was an early morning in 1917 at Yale Field in Connecticut. The area had been taken over by the U.S. Army for training, and a group of young soldiers was there, preparing for World War I across the Atlantic.

At some point a medium-sized dog wandered onto the field, and took an interest in the young men. They befriended each other, and Private J. Robert Conroy liked him enough to take back to their base that night.

The dog, though officially not supposed to be there, quickly became a part of the camp. He got used to the daily routine of orders and bugle calls. He even learned to salute: when he saw humans all doing it around him, he'd put his right paw on his eyebrow.

Eventually Conroy and his division were ready to ship out for the war in Europe. Rather than abandon the dog (now named Stubby) they smuggled him (under coats) aboard the troopship S.S. Minnesota for the journey across the sea.

Stubby turned out to be far more of a dog than his finders ever expected. Staying with his owners, he served in combat in France. He lived in the frontline trenches with the 26th Infantry (102nd division), for over 18 months. His first battle was in February, 1918, and overall he fought in 4 major offenses and 18 ground battles.

Frontline trench warfare is a nightmare, but Stubby, like his fellow soldiers, learned to live with it. At one point his position was under 24-hour continuous enemy gunfire and shelling for over a month. He never deserted his company or position.

In April, 1918, he was wounded by an enemy hand grenade, and sent to Red Cross facilities. While recovering he improved morale there by routinely visiting other wounded soldiers. After healing he went back to his company in the front.

Later that year he miraculously survived a gas attack in the new era of chemical warfare (though was extremely ill for several days afterward). He quickly learned to recognize the smell long before his primate colleagues could. Later, when the Germans launched another surprise gas attack in the early morning, Stubby noticed it first. He ran through the trenches, barking and even biting his comrades to waken them so they could put on their masks. Since there were no gas mask to fit him, after spreading the alert he'd run out of range behind the trench and wait there until the all-clear was sounded.

His keen ears could hear the high-pitched whine of incoming shells before humans could, and his warning barks gave his friends an extra few precious seconds to take cover.

Stubby - of his own accord - undertook some of the most dangerous missions of the war, searching no-mans-land between trenches for wounded soldiers. He could differentiate between English and German speech, and successfully led medical teams to the injured. He also was able to lead dazed, but walking, soldiers back to safety. How many lives he saved is unknown.

Later, Stubby and his men were deployed to the battle of Argonne Forest. There, while walking around on his own, he single-handedly caught a German spy that had slipped behind allied lines to map their formations. Stubby detected him behind a bush, raised the alarm, and then detained him (by holding onto the back of his pants) until 2-legged soldiers could arrive.

For his remarkable heroism and skills, the commanding officer of the 102nd division recommended him for promotion, and Stubby became Sergeant Stubby - now outranking his owner, Corporal Conroy.

Stubby's remarkable skills extended beyond the battlefield. During a visit to Paris with Corporal Conroy, Stubby suddenly dashed out into traffic and saved a young girl who was about to be struck by a car.

After allied forces liberated the town of Château-Thierry, the local women made him a chamois coat. It kept him warm and was also used for his growing collection of medals, including the Purple Heart.

After the armistice, Corporal Conroy returned home with his friend. Stubby was now a celebrity, routinely leading parades. He met 3 Presidents and was made a life member of the American Foreign Legion and Red Cross. In one instance he received a distinguished service award, presented by no less than the fabled American General, John "Blackjack" Pershing.

Sergeant Stubby leading a victory parade. His heart was bigger than his body!

As the cheers faded the pair transitioned back to civilian life. Conroy enrolled in Georgetown law school, and Stubby found employment as the team's mascot. He often performed a football halftime show, pushing a ball around the field.

He died on March 16, 1926, with Conroy holding him. He is remembered by a brick at the World War I memorial and at the Smithsonian. The latter has his remains on display.

 

 

Thank you, veterans!

With my most sincere apologies to Gilbert & Sullivan

I am the very model of a modern Major-General.
I've information vegetable, animal, and extramarital
I know the men of power, and I quote affairs historical
From Clinton through to Spitzer, in order categorical
I'm very well acquainted, too, with matters infidelical
I understand positions, both the simple and quadratical.
About the bedroom theorem I'm teeming with a lot o' news,
With many cheerful facts about the secrets of my private muse.

I'm very good at integral and differential calculus;
I know the iPhone numbers of ladies infinitacus
In short, in matters vegetable, animal, and Sildenafil,
I am the very model of a modern Major-General.

I know our mythic history, Fatal Attraction and The Graduate;
I answer ads on Craigslist, I've a pretty taste to fornicate
I quote in hidden diaries my flings in far Arabious
When up-close I can tell peculiarities paralabious;
I can bounce undoubted playmates whilst on a waterbed afloat
I know the moaning chorus from my 8-track of ye olde Deep Throat
Then I can hum a fugue of which I've heard the panting din afore,
And secretly record them all with CIA gadgets galore.

Then I can put a lingerie bill on my private credit card
And teach you ev'ry detail of what it takes to get me hard
In short, in matters vegetable, animal, and genital,
I am the very model of a modern Major-General.

In fact, when I know the secrets of a Langley Hilton one-night-stand
When I can tell at sight a Trojan from a Durex lamb,
When at affairs as sorties and surprises is so fun to be,
And when I know precisely what is meant by "promiscuity"
When I have learnt what progress has been made in male gunnery,
When I know more of tactics than Hugh Hefner in a bunnery
In short, when I've a smattering of elemental adultery
You'll say a hotter Major-General has never before slept with thee.

For my orolingual knowledge, though I'm plucky and adventury,
For I have only been going down since the beginning of this century;
But still, in matters vegetable, animal, and extramarital,
I am the very model of a modern Major-General.


The above is only vaguely based on the recent events concerning General David Petraeus. It is not meant to be taken as anything other than silly satire, and a pathetic attempt to procrastinate on reading a pile of EEG's until tomorrow.

Thank you, S.M.O.D., for the original idea.

Rimshot

Dr. Grumpy: "So you've had speech therapy since the stroke. How did that go?"

Mrs. Kramden: "I think I'm doing better."

Mr. Kramden: "Oh yeah. Doc, I can definitely vouch for my wife being able to talk."

Mary's desk

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

Mr. Newpatient: "Yeah, my hand surgeon wants me to schedule an EMG with Dr. Grumpy."

Mary: "I can help you with that. Are you on any blood thinners?"

Mr. Newpatient: "I don't know. Am I?"

Mary: "Sir, you've never been here, so we have no information about you."

Mr. Newpatient: "Well, can you guys look at my medicines and tell me if any are blood thinners?"

Mary: "Sure, I can have the doctor review them... What are you taking?"

Mr. Newpatient: "I have no idea. Can you call my pharmacy for the list?"

Mary: "Um... What pharmacy do you go to?"

Mr. Newpatient: "I don't know. My wife always deals with that stuff."

Mary: "Is she there?"

Mr. Newpatient: "No. Can you call back later?"

Thank you for sharing

Dr. Grumpy: "I'll have Annie set up an MRI for you, and in the meantime..."

Ms. Rope: "Hey, do they have to tie me down to do the MRI?"

Dr. Grumpy: "No, not at all."

Ms. Rope: "That's too bad. I'm into that sort of thing."

Reflections

This post isn't funny. But I mean every word.

November 6 is always a day of special meaning to me. My first secretary (Kate) called it Independence Day.

It's the anniversary of my going into solo practice. Which, after many years, is still one of the best decisions of my life.

As most of you know, I started out with Humungous Neurology, but after a few years I got sick of endless partner meetings (AKA sociopath's roundtable), bizarre fluctuations in my allegedly fixed salary that no one could explain, office politics, and the utter bullshit that seems to come with a large medical practice. Accountants showing me charts of dollars earned vs. square footage of office space used per patient drove me nuts.

Most of the other docs at Humungous Neurology, Inc., told me I wouldn't make it on my own. That I'd be back soon. That there was no place in modern medicine for a solo doc.

But I left anyway. It was a gutsy move. I had a 1 year old. Mrs. Grumpy was pregnant with twins, and couldn't work. I hadn't run a business since age 12, when I sold used golf balls (I fished them out of a lake on a nearby course, and sold them from a card table to passing golfers). My dad helped me form a corporation, and connected me with a friendly accountant he knew.

Kate (who was here before Mary) and Annie came with me from Humungous Neurology, Inc. But my first receptionist was - my mom.

To add another item to the list of terrific things Mom has done, she became my first receptionist when Kate had to go out of town that first week. She patiently answered the phones and made notes in a scheduling book, while I frantically tried to get the phones and computers to work properly. I didn't see a single office patient that week due to a phone system meltdown (it traumatized me so much that I've never changed it since).

Kate left me after 4 years to take a job closer to her home. I was afraid I'd never replace her. I spent a sleepless night at home, and the next morning she introduced me to Mary, who she'd met working for another doctor in the building. She'd found her own awesome replacement in only one day. And Mary is still here, and still totally awesome.

Annie and I have now been together for a total of 14 years, and I can't imagine doing this without her.

I have no regrets about solo practice. It was a self-taught crash course in business: insurance, payroll, withholding taxes, purchasing supplies, etc. It certainly isn't for everyone. But when it's all said and done, I prefer this more than any group. Nobody argues with me about my choice of computers, or EMG machine, or ISP, or whatever. Nobody makes me look at Powerpoint presentations on lobby decor. And nobody shows me charts of dollars earned per square foot per patient.

I'm writing this to say "thank you" to those who have made it possible for me to be here: Annie, Kate, Mary, my parents, and (of course) Mrs. Grumpy. It takes a hell of a lot of patience (and too many other qualities to list) to put up with me.

And, of course, the patients. Without whom I'd have no practice or blog.

Thank you all so very much.

IG

Working on commission

Commission Guy: "Can I help you, sir?"

Dr. Grumpy: "I need a new iPhone case, one with a belt clip. Mine wore out and broke."

Commission Guy: "I can help you with that. You want one that lights up when you're talking?"

Dr. Grumpy: "No. Don't get me started on that."

Commission Guy: "All right, how about this one. It's on sale!"

Dr. Grumpy: "It's kind of thick... Not sure I need that."

Commission Guy: "It's a great deal, though! Normally $289, this week only $199!"

Dr. Grumpy: "ONLY $199? Uh, no, I just need something to protect it from scratches and stuff, like this $15 one here. Hey, do you have this kind in black? And with a belt clip?"

Commission Guy: "Yeah, but that won't protect your iPhone. You just said your last case broke. You need something sturdier."

Dr. Grumpy: "Maybe, but I'm not paying $199 for an iPhone case."

Commission Guy: "Your phone could get wet or dropped or something. Look at this case as an investment."

Dr. Grumpy: "Okay, I'm taking this one for $15 and going to check out. Thank you."

Commission Guy: "Wait! This $199 case is a great deal! It's bullet proof!"

Dr. Grumpy: "BULLET PROOF?"

Commission Guy: "Well, against a small caliber handgun, I mean. Couldn't you use that in an iPhone case?"

Dr. Grumpy: "I wear my phone on the right side of my belt. So, yes, if I'm worried about someone sneaking up and shooting me in the right hip I suppose it's useful. But I think I'll take my chances with the $15 case."

Commission Guy: "But..."

Dr. Grumpy: "Besides, if someone is shooting at me, the safety of my iPhone is the least of my worries."

I left and went to another store, where I got a cheap case. Upon getting home my curiosity got the best of me, and I looked online. The only bullet proof iPhone case I found was $650, and didn't look anything like what he was trying to sell me.

And then I had these visions of Linda Carter, in a 1977 Wonder Woman outfit, using an iPhone instead of her magic bracelets to deflect bullets while fighting bad guys.

Fun with online medical surveys

What happens to the documents if I take the survey in French?

Claustrophobia

"Doc, I was a Navy Seal. We trained in all kinds of stuff. I got crammed into the torpedo tubes of a submarine to land on enemy islands. I sat balled up in a fetal position for hours in the dark cargo hold of a bomber to parachute out. I fought in combat in 2 wars. But holy shit, I couldn't handle that MRI to save my life."

Dear Patient,

I know you did it. Why, I don't have a clue.

A blue sponge that I use once a week for cleaning Ed's bowl has been sitting on the edge of that sink for 12 years. The sponge changes every few years, usually when it starts falling apart. It's not used for anything else.

I'd noted it there when I took you in. Mary pulled me out for 5 minutes to take an ER call, and when I went back in it was gone. You were standing in the center of the room, zipping your purse closed. And the sponge had vanished.

I gave you the benefit of the doubt, but a search of the room didn't turn it up. So I took emergency measures, and brought a new one from home the next day.

I have no idea why anyone would want to steal a used sponge, especially from a doctor's office. I mean, it's nowhere near the kitchen, and since its sitting next to a fish net and bottle of Betta water prep I figure it's pretty obvious what it's for (sorry if I came back you before you could grab the net, too).

The sponge has been used to scrub off countless fish turds, the fuzzy goop that grows on the glass balls at the bottom during the summer months, and whatever other disgusting things are in Ed's water. I hope you aren't using it in your kitchen, or for personal hygiene.

I don't think you're so destitute as to be unable to afford one (they cost 25¢, FFS). I also hope you didn't mistake it for some kind of snack, and are now lying in ICU dying of some horrible fish shit poisoning.

Perhaps you're secretly planning on taking it to the state board of health, to see what they can culture out of it. If the plan is to get me in trouble with them, I doubt they'll care. I'm not preparing food or medicine in that sink, or washing anything. It's used solely for changing a fish once a week.

However, we know who you are. If you read this, and are currently overwrought with guilt from your life of crime, please confess at your next appointment. In exchange I will not press charges, but will gladly give you an unopened, clean, kitchen sponge, as I feel sorry that you must resort to such lawlessness.

Yours truly,

Ibee Grumpy, M.D.

p.s. I also have an extra fish net if you need one.

Communication

Dr. Pissy still uses paper charts, and has a room near my office where he stores inactive ones.

1-2 times a year his secretary makes a list of patients who have died, and moves their charts from the front shelves to a box in the storage room.

Yesterday I was talking to Mr. Patient in my office, when Pissy's secretary wandered past my door behind him. She was struggling with a pile of charts, and looked like she might drop one at any minute.

Being a gentleman (or at least trying) I stopped talking to Mr. Patient and called out, "Hey, do you need a hand with those?"

Pissy's secretary said "No, I'm okay. I'm just putting a bunch of dead people in a box."

Mr. Patient looked startled, to say the least.

I just had to do it

I was on call this weekend, and overheard...


Unit clerk (flipping through a Rolodex) "Hey, does anyone know Jenny's number?"

Dr. Grumpy: "867-5309."

Hurricane news

As the warnings for Hurricane Sandy continue to come in ("Please remain calm, we could all be killed"), my reader Tanya noticed this incredible combination of weather alerts and an advertisement on her TV:

Thank you, Tanya!

p.s. I apologize in advance if I'm unable to post for the next few days due to power outages.

The Marines: Looking for a few good men

Tomorrow, in Washington, D.C., is the Marine Corps Marathon.

My reader Amy, while trying to figure out traffic routes, discovered this, uh, interesting map of the marathon's course:

I AM NOT MAKING THIS UP! The complete map, including the above, um, segment, can be seen here.

Thank you, Amy!

Thanks, Siri

I've gotten into the habit of having Siri do minor stuff for me. Sometimes she works fine, other times... not so much.

Last night I had a marketing interview, which finished ahead of schedule. So as I got in my car I picked up the phone and said "Siri, send a text to Mrs. Grumpy: I'm done, the interview went fast."

Upon getting home I found out she received "I'm done. The interviewer and I went to France."

October 25, 1962

The North American black bear (ursus americanus) is the smallest of the continent's 3 bear species, and (comparatively) the most docile. It generally prefers to avoid humans and be left alone.


It was the Cuban missile crisis. The 2 superpowers were locked in a potentially lethal stare-down that affected lives across the globe. Both were on a hair trigger, watching for the other to make the first move.

Volk Field, in Wisconsin, wasn't one of America's larger bases. It was primarily used for pilot training and didn't even have a control tower. Planes were directed from a command center at Duluth.

In the current state of readiness, though, the Air Force had dispersed American warplanes to many such small bases across the north. Tensions were high. There was fear that Soviet agents would try to destroy the planes or runways prior to a first strike. Extra alarms had been hurriedly rigged up everywhere, alongside the dreaded klaxon that meant "launch nuclear bombers." Armed sentries patrolled constantly.

There were no drills. The pilots and planes were ready. The men had been told that, given the world situation, if the alarm sounded it was the real thing.

It was around midnight when a sentry patrolling the Duluth command center noticed a figure just outside the security fence. As he approached, it suddenly began climbing the fence, trying to get into the restricted area. This might be it. A Russian spy, trying to sabotage the bases to let the Soviets get in a first nuclear strike.

The guard fired his gun at the figure and hit the alarm button that warned of a ground intruder. The trespasser jumped off the fence and ran back into the forest on all fours- a large black bear. But the sabotage alarm had now been activated at all the bases under Duluth's command, sending armed guards racing to protect the planes.

Except at Volk Field.

Due to an undetected wiring error when the base was hurriedly readied for bombers, the nuclear war klaxon sounded there.

Fighter crews scrambled to planes. Their mission (likely one-way) was to intercept long-range Soviet bombers coming over the North Pole. Aside from other weapons, each American plane carried a single AIR-2 "Genie" rocket with a 1.5 kiloton nuclear warhead to be used against enemy formations. The Russians, once they detected American planes heading for them, would certainly retaliate in kind.

They taxied down the runway to Armageddon. Once airborne they couldn't be recalled- they were under orders to assume any ground communication telling them to come back was from the enemy. There was no control tower to correct the error before they took off.

A quick-thinking officer in the base's command center called Duluth, and learned of the mistake. There was no war, only an errant bear. He hurriedly jumped into a truck, turned on the flashing lights, and drove onto the runway, blocking the fighters from taking off and alerting them to the mistake. He was able to stop them just in time.

It was another close call.

Those involved didn't even know what had happened for another 25 years, when the incident was officially declassified.

Life on the edge is scary.

Mary, call security.

Dr. Grumpy: "Are you married?"

Mrs. Latrodectus: "Widowed... Am I considered a widow if I killed my husband?"

Dr. Grumpy: "Um, I really don't know."

Mrs. Latrodectus: "Then just put down that I'm single."

Memories...

When I was in residency, there was a married couple in the program, Peter and Stephanie. They were often on call together, one supervising ICU and the other wards, or vice versa. Both were seniors, and I was just starting out.

One night when I was working with Peter, there was a code. Both on-call teams ran to it. Since I was the junior resident my job was to stay out of the way, but look like I was doing something important. Like leaning against a wall to keep it from collapsing.

Peter and Stephanie were at the head of the bed. She was setting up to intubate the patient, and Peter was watching the heart monitor and calling for meds (they were REALLY into this sort of shit. Another resident once told me that codes were probably their idea of foreplay). At one point Peter tore off a rhythm strip, handed it to me, turned back to the bed and yelled, "Sweetie! Can you intubate him now?"

There was a (pardon the phrase) dead silence.

The code stopped for a few seconds and all eyes were on the married couple. Finally, Stephanie said (with icicles on every syllable):

"Don't call me 'Sweetie' during a code."

Then she intubated the guy, and the code continued.

I don't remember if the patient made it, but I know I almost lost it.

Skool Nerse Time

Ms. Concern: "Hello?"

Mrs. Grumpy: "Hi, this is Nurse Grumpy, the school nurse at Douglas C. Kenney Elementary School, calling about your daughter, Karen."

Ms. Concern: "Yes?"

Mrs. Grumpy: "She took a bite of a friend's sandwich at lunch, and it had peanuts in it. Karen swelled up really badly, and had trouble breathing. I used one of our emergency EpiPens on her. She's much better now, and resting in my office."

Ms. Concern: "Okay. Do I need to send someone to get her?"

Mrs. Grumpy: "Yeah, but I went looking through her medical forms here. Did you know she's seriously allergic to peanuts?"

Ms. Concern: "Oh, yeah, she's been that way since she was five."

Mrs. Grumpy: "But on the allergy form you filled out just 2 weeks ago you wrote 'no allergies'!"

Ms. Concern: "That's because I don't have time for school paperwork."

Mrs. Grumpy: "Well, it really helps to have an accurate medical history, for when things like this happen."

Ms. Concern: "Her pediatrician knows, and I know. Why does it have to be your business, too?"

Mrs. Grumpy (sigh): "Do you have an EpiPen for her at home?"

Ms. Concern: "Of course. I keep two of them here."

Mrs. Grumpy: "Well can you please bring one to school? So we have it available in case this happens again?"

Ms. Concern: "They both expired years ago."

On the radio

This is the recording of an actual phone call to a Fargo radio station earlier this month.





Thank you, Tanya!

Family

Mr. Spouse: "What kind of side effects does this have?"

Dr. Grumpy: "A few. It can cause nightmares..."

Mr. Spouse: "Hell, so can my mother-in-law."

Literally

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

Mr. Clock: "My dad died early."

Dr. Grumpy: "Like in his 20's? Or 30's?"

Mr. Clock: "No, I mean between 4:00 and 5:00 in the morning."

Mary's desk, October 16, 2012

At the check-out desk.

Mary: "All right, so your follow-up appointment is next month, here's a reminder card... and this is your receipt for today's co-pay... Annie will call you to schedule the tests... Anything else?"

Mr. Suit: "Could you please fax something for me?"

Mary: "Sure, is it the form the doctor filled out?"

Mr. Suit: "No, it's this business report." (opens briefcase, pulls out HUGE folder and a list of fax numbers) "I need you to send a copy to my company's New York office, another to Calgary, one to Los Angeles, and..."

Mary: "Um, no. I thought it was something for your medical care. That sort of thing you'll have to have your own secretary do."

Mr. Suit: "Well, she's busy preparing reports like this."

Nigel? Are you out there?

I was doing an epilepsy survey last night and suddenly realized that

(drumroll)

This survey goes up to 11!!!

Coincidence

Mary usually shows up around 7:30 each morning. Today, at about 7:45, she called my cell.

Dr. Grumpy: "Hi, you okay?"

Mary: "Yeah, but I'm stuck in traffic, there's a big wreck at 12th and Carson. Looks like a blue car smashed into a truck, and the intersection is closed. It's going to be a while. Sorry."

Dr. Grumpy: "I'm glad you're okay. Don't worry about it. I'll see you when you get here."

I wandered up to her desk and got paperwork ready for the new patient coming at 8:00, then began looking through some MRI reports. As I was sitting there a voicemail came in:

"Hi, I have an appointment 8:00, and I'm not going to be able to make it.  Some asshole in a blue car rear-ended my truck on Carson street on the way to your office and..."

Picture day

Yesterday we made our usual weekend run to Costco to load up on Diet Coke and other life sustaining nutrients.

Starting in October, Costco puts up large displays of Christmas trees and other holiday home decorations, some of which can be quite elaborate, to show people how the items look out of the box.

As we walked around we noticed 2-3 families, each with their kids nicely dressed up in Christmas-type outfits. They were posing the youngsters in front of the displays and taking pictures for family Christmas cards.

Advantages of getting a flu shot

At your friend the pediatrician's office: Cool band-aids!

Patient quote of the day

"When things are the same they're the same, but when they're different they're not the same."

Practice makes perfect

I'm examining Mr. Patient, with his wife sitting off to the side.


Dr. Grumpy: "Okay, hold your hands out in front, like this... now close your eyes... good, now open your eyes, and tap your right fingers like this... okay, now your left fingers..."


Out of the corner of my eye I notice Mrs. Patient doing the same things I'm asking her husband to do.


Dr. Grumpy: "Ma'am, why are you doing that?"

Mrs. Patient: "Just practicing, in case I ever need to see a neurologist."

Great moments in Jewish parenting

"DAD! YOU DON'T KNOW WHAT IT'S LIKE THAT YOU TOOK AWAY MY NINTENDO 3DS! YOU TOOK AWAY MY DIGNITY TOO! THIS IS WHAT IT WAS LIKE TO BE ONE OF THE MACCABEES, WHEN PHARAOH MADE THEM WORSHIP HIS GODS AND MADE THEM SLAVES AND JUDAH SAW THE BURNING BUSH FOR 8 DAYS AND SENT MOSES WITH A MENORAH TO TELL THE ROMANS TO LET MY PEOPLE GO!!!"