22 hours ago
Tuesday, January 31, 2012
RalPh: "Hi, this is RalPh, the pharmacist over at local grocery. I'm calling about a script you wrote for Valerie Smith yesterday, for her Valium."
Dr. Grumpy: "Is there a problem? She gets it every month."
RalPh: "It's her name. You misspelled it."
Dr. Grumpy: "What did I write?"
RalPh: "Instead of Valerie Smith you wrote Valium Smith."
Dr. Grumpy: "Holy crap. That's awesome."
RalPh: "Yeah, it took a while for the tech and I to stop laughing enough to call you."
Posted by Grumpy, M.D. at 6:14 AM
Monday, January 30, 2012
Sunday, January 29, 2012
So I called over there a minute ago to talk to her nurse:
Dr. Grumpy: "How'd she do this morning?"
Nurse Icu: "She's more awake, and we got her off the ventilator, but may have to put her back on again."
Dr. Grumpy: "Why? Is she still having trouble breathing?"
Nurse Icu: "No, she's just a bitch."
Posted by Grumpy, M.D. at 10:21 AM
Saturday, January 28, 2012
This pair of 17-year old guys, who live in Toronto, successfully launched a Lego figure into near-space (14 miles up) using a weather balloon, a lot of weekends, and costing about $400.
Just for fun.
They even sent 4 cameras and a GPS tracker with him, so they could film and recover him.
This is the movie they posted.
I'm thoroughly impressed guys. That's really cool.
Posted by Grumpy, M.D. at 10:18 AM
Friday, January 27, 2012
Dr. Grumpy: "No."
Posted by Grumpy, M.D. at 6:41 AM
Thursday, January 26, 2012
So does anyone else out there think this ad campaign:
Would be a helluva lot better if it featured the Old Spice Guy?
"Smell like a man, man."
Posted by Grumpy, M.D. at 5:31 PM
Mrs. Xanax: "It's very stressful. My sister and I aren't speaking to each other right now."
Dr. Grumpy: "I'm sorry to hear that. Is this the one who's having a baby? Last time you were here you were knitting a blanket for her?"
Mrs. Xanax: "Yeah, but that's where it all started. I was going to have the blanket done when she got to 36 weeks, but then she had all kinds of complications, and had a seizure, and they had to deliver the baby at 29 weeks, and the blanket wasn't done by then. Now she just spends all her time at the hospital visiting the baby, and I finally called and told her that I wasn't happy about how she ruined my plans to have the blanket ready in time, and that it's not all about her."
Posted by Grumpy, M.D. at 6:36 AM
Wednesday, January 25, 2012
In Oklahoma, however, an elected representative of the people (state Senator Ralph Shortey) has decided that eating human fetuses is a SERIOUS problem in America. If not now, it still could become one by, say, 2022.
So we need to act now to keep this from happening. Because, with all the other issues facing our society, people eating fetuses is apparently one of the bigger ones. At least to Mr. Shortey.
So he has, I SWEAR, introduced a bill to ban the practice of using human fetuses in food products.
Comically, he even admits that he's unaware of anyone actually doing this, but decided the law is needed because he researched the subject on the internet.
And we all know how accurate that is.
Thank you, Ed!
Posted by Grumpy, M.D. at 12:11 PM
Tuesday, January 24, 2012
In residency it continues, with most programs having at lease 1 daily conference. Residents who don't show up risk incurring the wrath of the program director.
In the REAL WORLD this stuff continues. It's worst if you stay in academics, but even in private practice there are CME courses, annual meetings, etc. to go to (okay, I haven't gone to any for over 12 years, but I'm atypical). My idol, Dr. Oscar London, pointed out that by the time they finish training most doctors are conditioned to doze off when they hear "May I have the first slide, please."
But I digress.
Anyway, the point here is that these meetings are BORING. Except for the occasional fistfight between doctors breaking out (I personally witnessed one at a tumor board between a medical oncologist and radiation oncologist) these things are dreary as hell.
But there are rare exceptions. The one that will likely live on as THE MOST INTERESTING MEDICAL PRESENTATION EVER was in 1983, at the American Urodynamics Association annual meeting.
The presenter was Sir Giles Brindley (knighted in 1986 for bioengineering research).
At this point, I'm going to send you over to a summary article for the remarkable story of that day.
Thank you, Science Marches On Department!
Posted by Grumpy, M.D. at 7:05 AM
Monday, January 23, 2012
Sunday, January 22, 2012
Saturday, January 21, 2012
Friday, January 20, 2012
Unfortunately, the power was out for a few hours this afternoon due to the snowstorm. This is a major inconvenience, but what can you do? So the patients and I work through it as best we can.
Not the ortho doc, though. 10 minutes after it went out he came storming out of an exam room and went up to his secretary.
"Suzy! This power outage is unacceptable! Call the electric company and have them turn it back on immediately!"
Pissy and I had a hard time not cackling as he marched back into the exam room.
Posted by Grumpy, M.D. at 9:11 PM
Dr. Grumpy: "Have you had any neck pain?"
Mr. Awesome: "I have no idea."
Dr. Grumpy: "You don't know if you have neck pain?"
Mr. Awesome: "Look, doc, I'm 89. If you pay attention to every ache and pain at my age you become a fucking hypochondriac."
Posted by Grumpy, M.D. at 6:34 AM
Thursday, January 19, 2012
Mr. Pill: "I don't know. The pharmacy never filled it."
Dr. Grumpy: "Whaaa..."
Mr. Pill: "I dropped it off last month, but they never called to tell me it was ready."
Dr. Grumpy: "Did you go by to get it? Or call them to ask if it was ready?"
Mr. Pill: "Was I supposed to?"
Posted by Grumpy, M.D. at 6:28 AM
Wednesday, January 18, 2012
So here's a story that you won't hear on the news or from a politico's mouth.
I have a patient, an elderly white man. His wife died 2 years ago, and he has no kids or local siblings. In 2010 he developed a relentlessly progressive neurological disease, with increasing disability over time.
A long time ago, when he was a teenager, his parents were prominent members of the Grumpyville community. When a group of black families wanted to build a community center, the majority of Grumpyville whites fought like hell to keep them from doing so. Because, after all, they were black people.
But Mr. Patient's parents were different. They had this bizarre (for the time) view that people were equal, and should be treated fairly. So they stood up against the majority of the community, bought a parcel of land for the community center, and then financed a large part of it out of their own pockets.
So it got built. And became a successful (and still in existence) black center in Grumpyville. Years went by. Mr. Patient's parents grew old and died, and then Mr. Patient grew old and sick.
There's nobody at the community center old enough to remember how it got started. Although the center's humble origins are doubtless memorialized somewhere on a wall or booklet, most of its members are my age or younger now.
Mr. Patient is stubborn (like most guys) and been reluctant to leave the house he and his wife have owned for 50 years. To him moving into a care home was out of the question. His financial resources, though comfortable, didn't allow him to hire much in the way of outside help. And he was too stubborn to call friends for help. So he worsened, and became increasingly unable to care for his home and self.
Usually these situations end in disaster. The patient is found lying on the floor, dead or near it, after the postman notices no one is getting the mail. But this one was different.
Last month, through the community grapevine, one of the administrators of the black community center heard about white Mr. Patient, and realized who his parents were. He contacted him to offer help, and to my surprise, Mr. Patient accepted.
So now Mr. Patient is able to continue living at his house because volunteers from the community center, all born long after the place was established, come to his home a few times a week. They bring him meals and groceries, help with the upkeep of the house, and are allowing him to stay there as long as possible.
That's what real measures of human change are.
Posted by Grumpy, M.D. at 5:48 AM
Tuesday, January 17, 2012
Dr. Grumpy: "This is Dr. Grumpy."
Dr. Dislike: "Hi, does Fukitol interact with Noshakes?"
Dr. Grumpy: "Is one of my patients over there?"
Dr. Dislike: "No, I just want to know for someone I'm seeing tomorrow."
Dr. Grumpy: "You had me interrupted with a patient to ask me a simple drug question?"
Dr. Dislike: "I'm very busy. I don't have time for this. Answer the question!"
Dr. Grumpy: "Look it up on ePocrates." (hangs up)
Posted by Grumpy, M.D. at 7:17 AM
Monday, January 16, 2012
As a result, my drooling, incontinent 92 year old male stroke patient, with advanced Alzheimer's disease, is wearing a T-shirt that says "I'm a proud new Daddy!"
With little baby footprints under the word "Daddy."
Posted by Grumpy, M.D. at 5:57 AM
Saturday, January 14, 2012
Next we have a store computer showing the blue screen of death, which is generally NOT a selling point:
A reader sent in this coupon for a "fluid exchange". He commented that "if it didn't show a picture of a car, I'd wonder what they were selling with that headline."
Having the place named "BJ's" probably doesn't help, either.
And, lastly, for those of you trying to lose weight for New Year's, keep in mind that there are always alternatives to diet and exercise.
Posted by Grumpy, M.D. at 10:19 AM
Friday, January 13, 2012
Mrs. FosterGrant: "Well I don't feel any better! I have a horrible migraine today. Look at me! I'm even having to wear my sunglasses indoors!"
Dr. Grumpy: "Uh, you don't have sunglasses on."
Mrs. Fostergrant: "I don't?" (feels face, then rummages through purse, puts on sunglasses) "Now I do! See? I feel awful!"
Posted by Grumpy, M.D. at 7:09 AM
Thursday, January 12, 2012
Dr. Grumpy: "This is Dr. Grumpy."
Dr. Webster: "Hi, I'm the hospitalist taking care of Mrs. Migraine, and I have a question about your note."
Dr. Grumpy: "Okay."
Dr. Webster: "This morning you wrote: 'Brain MRI didn't show an ominous cause for her headaches'."
Dr. Grumpy: "Yes?"
Dr. Webster: "What does 'ominous' mean?"
Posted by Grumpy, M.D. at 7:30 AM
Wednesday, January 11, 2012
Mr. Funky: "I'm not happy about this."
Dr. Grumpy: "Not happy about what?"
Mr. Funky: "My visit co-pay. I paid $25 the first time I came here, and then another $25 at my last visit, and now I'm going to have to pay another $25 today. That's $75 to see you for the same damn problem."
Dr. Grumpy: "I understand, but I don't set your co-pay."
Mr. Funky: "It should be one co-pay covers all visits for the year, or something."
Dr. Grumpy: "Your insurance company is the one who decides your co-pay, not me."
Mr. Funky: "Yeah, but I bet you're sleeping with some insurance company bitch."
Posted by Grumpy, M.D. at 3:01 PM
Tuesday, January 10, 2012
Mr. Scheele: "Great! It knocked them right out. But I need another tank."
Dr. Grumpy: "They should last a while... How often do you have to use it?"
Mr. Scheele: "Oh, not that often. It's for my dog. He has lung problems, and it's cheaper to get a tank through you than my vet."
Posted by Grumpy, M.D. at 7:16 AM
Monday, January 9, 2012
Posted by Grumpy, M.D. at 5:37 PM
Dr. Grumpy: "This is Dr. Grumpy, returning a page."
RalPh: "Hi, my name is RalPh, and I'm a patient of Dr. Brain's. I need a refill called in for my Sarcasma, and his office never called me back on Friday."
Dr. Grumpy: "That's fine. What's your pharmacy number?"
Dr. Grumpy: "Okay, I'll call it in right now."
Hangs up, dials 867-5309.
RalPh: "Local Pharmacy, this is RalPh. Can I help you?"
Dr. Grumpy: "Um, didn't I just talk to you?"
RalPh: "Yeah, I'm a pharmacist. You calling in a script?"
Posted by Grumpy, M.D. at 7:15 AM
Saturday, January 7, 2012
Most of us are used to the concept of time zones. Central Time, Pacific Time, whatever. You move a few hours up or down depending on how far east/west you are.
Boy Scout Time (BST), however, is a time zone that has absolutely no basis in reality. Here's how it works:
Some guy allegedly in charge sends out an email/phone message/smoke signal/semaphore flag that we will meet in the parking of local church/school/mortuary at 7:30 in the morning.
7:25: Grumpymobile containing Frank, Craig, and I shows up, joining 1-2 other cars.
7:30: Nothing happens.
7:38: Guy who sent email out shows up, makes lame excuse.
7:40: Two more cars show up.
7:45: 3 other cars show up, one forgot something (like a kid), goes back home for it.
7:47: Guy who sent email wanders around trying to do a head count and complains about people being unreliable.
7:48: Single mom shows up, blames her ex for giving her the wrong time.
7:50 Another car shows up. Driver asks if we want anything from Starbucks, then leaves to go get his own.
7:51: Guy who sent email starts calling people who aren't there but had confirmed. 50% of the time he gets voicemail, 50% he wakes them up.
7:55: Person who left to get something from home is back.
8:00 Guy who went to Starbucks returns. Got my order wrong.
8:05: Email guy finally gives up, announces everyone should follow him to the day's activity, discovers he left address at home, calls and wakes up his wife to look for it on the kitchen counter.
8:15 After we all leave, insane parents who showed afterwards call and ask as to come back to the parking lot so they can follow, too. Email guy makes an illegal U-turn to go back, and we all follow him. Because we are morons. And the local traffic cop turns on his lights and siren.
And this is how Boy Scout Time works.
Friday, January 6, 2012
Mrs. Image: "Hi, I need to set up my MRI."
Annie: "Hmmm... You're not on my list. When was the MRI ordered?"
Mrs. Image: "Last week."
Annie: "That's weird. I can't find you in our computer. Did Dr. Grumpy see you at the hospital?"
Mrs. Image: "I've never seen Dr. Grumpy."
Annie: "Um... I can't set up an MRI when you're not our patient. You'll have to call the doctor who ordered it."
Mrs. Image: "But his staff is busy taking care of patients."
Posted by Grumpy, M.D. at 7:18 AM
Thursday, January 5, 2012
Mr. Shakin: "47 minutes. See, it happened while I was on the phone with my Mom. I'd just dialed her up, then I blacked out. When I came to the phone showed the call was still going on, and it was at 47 minutes. Mom was still on the other end, and driving over to my place."
Dr. Grumpy: "So then what..."
Mr. Shakin: "So, can you write a note for me? Because I only get 500 minutes a month, and want a letter for my cell phone company so they'll credit me for the 47 minutes I was out, because it wasn't my fault."
Posted by Grumpy, M.D. at 6:54 AM
Wednesday, January 4, 2012
Mr. Vertebrae: "Yeah, I have an appointment with Dr. Grumpy on Thursday, and am trying to decide if I should come in."
Mary: "Okay, are you still having problems?"
Mr. Vertebrae: "Yeah, but I don't know if it's worth the drive. What do you think?"
Mary: "Well, I recommend you come in, but I can't make that decision for you."
Mr. Vertebrae: "Well, I'm just not sure... What do you think? Don't you have a medical degree?"
Mary: "No, sir, I'm his secretary. I have a high school degree."
Mr. Vertebrae: "A high school degree? And you work at a doctor's office?"
Mary: "Sir, you'd be seeing Dr. Grumpy, not me, and he's a board-certified..."
Mr. Vertebrae: "Just cancel the appointment. I'm going to an office with qualified staff."
Posted by Grumpy, M.D. at 6:17 AM
Tuesday, January 3, 2012
Monday, January 2, 2012
However, the same protein also increases in one other human condition.
And I just can't wait to tell someone "The labs show you're pregnant. Or have Alzheimer's disease. Or both."
Posted by Grumpy, M.D. at 3:53 AM