Monday, August 20, 2018

All I need is a miracle

Aimovig is the first FDA-approved drug specifically developed to prevent migraines.

It’s getting a lot of press. Some articles talk about it as a breakthrough, some on how it shows the pharmaceutical industry is now focusing on migraine as a real disease, some on how it represents a new era in diseases that affect predominantly women, and many other spins.

Of course, it isn’t alone. There are 2-3 similar agents on the launch pads to join it in the next year.

From my daily office view, the phone calls (and drug reps) come in, and inevitably I hear it referred to as “the miracle drug.”

“I want to try the miracle drug.”

“I saw an ad for that miracle drug.”

“Someone at work told me about this miracle drug.”

Amgen, to their credit (not that the FDA would allow it, anyway), has NOT claimed it’s a miracle drug. The information they provide doctors is the usual glossy graphics surrounding dry statistics and obligatory legal wording. (Note - neither Amgen, nor their competitors, or anyone else, has paid me to write this post. These are my own thoughts).

People seem to need to think a drug is a miracle, in spite of all evidence to the contrary. This isn’t a slight against Aimovig - it’s human nature. Just as people thought of the Titanic as unsinkable (a claim never in reality made by her builders, owners, or officers) there’s a desire to believe human intelligence has somehow overcome a problem and cured it.

It’s not like Aimovig is the first drug to get that label, either. Botox is a miracle drug. So was Imitrex in 1992. Interleukin-2 in the 1980’s. Penicillin in the 1940’s. Willow bark in 500 B.C. (that's where Aspirin came from, people). And too many others to list.

Are these bad drugs? Far from it. But, like every other drug ever discovered, they have a lot of limitations. They work for some conditions, but not others. They ALL have side effects (if someone tries to tell you a drug or supplement doesn’t have any side effects, they’re lying). And, most importantly, humans are not a biologically identical group. No medication will work for everyone. If you read the stats on any med you’ll see that approval is based on a percentage of people who respond to it - and it’s never 100%.

There is absolutely no way to predict with 100% certainty who will - or won’t - respond to any given drug. For that matter, there’s no way to know who will - or -won’t - have side effects, or even which ones.

This is a trial-and-error crapshoot, people. We make decisions based on facts, but an educated guess is still just that - a guess.

There is no such thing as a “miracle drug. " And there never will be.

You won’t hear me, or hopefully any other reputable physician, ever tell you that a drug or surgery or whatever is guaranteed to cure you, or has no chance of harming you. Medicine is about as imperfect a science as there is.

If someone is making such a claim to you, run away. They just want your money, and don’t care about helping you.

I’m not knocking Aimovig. For some people it will be life changing. For others it won’t do a damn thing. Still others will have an unpleasant side-effect. The jury on it and its cousins is still out, and will be for at least 2-3 more years.

But don’t go into any treatment plan, for anything, thinking it’s going to be a miracle. There’s nothing wrong with being hopeful, but you can still do that and keep reality in mind. Because in this field, there are no guarantees.




Wednesday, August 15, 2018

Memories...




In the mid-80's I had a medical school interview in Chicago. It ran over and finished about 45 minutes before my flight home. And the drive to the airport was around 45-60 minutes.

I went out and hailed a cab. The driver was a dude with a scruffy beard. I climbed in and asked him if he’d be able to get me there on time.

He looked at me in the rear-view mirror and said “do you mind if I smoke?”

I said no.

He lit a cigarette, mumbled “fuck” then yelled “HANG ON!” and slammed on the pedal.

I discovered my seatbelt didn’t work, but just kept my mouth shut.

I made my flight.

I gave him a good tip.

Monday, August 13, 2018

Annie's desk

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

Mr. Consultant: "Hi, I saw Dr. Grumpy last week, and he told me to increase my dose of Flookadook from once a day to twice a day, and it hasn't helped my symptoms at all."

Annie: "Okay, did the increase cause any side effects?"

Mr. Consultant: "No. Why would it cause side effects? I'm still taking it once a day, and haven't had any problems with it."

Annie: "But you said you increased the dose to twice a day?"

Mr. Consultant: "No, I said Dr. Grumpy told me to do that. I didn't say I had."

Annie: "So..."

Mr. Consultant: "Anyway, my symptoms aren't any better. Can you please ask Dr. Grumpy what I should do?"

Thursday, August 9, 2018

Bueller? Bueller?

Seen in a chart:


Monday, August 6, 2018

Sympathy for the devil

Please allow me to introduce myself. I’m Dr. Grumpy’s evil arch-enemy, neurological disease.

I’ve been around for a long, long year, stole many a man’s (and woman’s) soul to waste.

In the last year I’ve been in the headlines for my trifecta of stars with Parkinson’s disease: Neil Diamond, Alan Alda, and Linda Ronstadt.

The funny thing is that you people often believe life decisions or habits or activities can change your risk of meeting me. That may work for my friend heart disease, or for certain types of cancers, but me? Don’t kid yourself. Plenty of the things I do don’t have a known cause or risk factors, regardless of what some guy on the internet or TV tell you (and I bet he's trying to sell you something, too, claiming to cure it).

Others believe that a virtuous life will keep me away, or that I’m a punishment from God for being evil. You want good and evil? How about Pope John Paul II and Adolf Hitler (both Parkinson’s disease)?  You American evangelicals think you’re immune? How about Billy Graham (Normal Pressure Hydrocephalus). You think I care?

I especially love it when you try to attach political significance to me, like I’m here to punish someone on the side you disagree with. Let’s talk about Glioblastoma Multiforme, probably the most dreaded form of cancer there is. Here are 2 names from across the aisle, Ted Kennedy and John McCain. Here's another pair: Lee Atwater and Beau Biden. Political affiliations and age don't matter to me. The last pair were 40 and 46 respectively.

Before I forget, let’s talk about Alzheimer's disease: Ronald Reagan. Rita Hayworth. Charlton Heston. Glen Campbell. James Stewart. Perry Como. Jackie Fisher. Charles Bronson. Peter Falk. E.B. White. Rosa Parks. Burgess Meredith. Norman Rockwell. James Doohan. Fred Trump (yeah, his dad).

How about entertainers (besides those I mentioned above)? Slim Pickens. Gene Siskel, Ethel Merman, and George Gershwin (all Glioblastoma). Michael J. Fox, George H. W. Bush, Muhammad Ali (all Parkinson’s Disease). Terry Garr, Annette Funicello, Ann Romney, Richard Pryor, Montel Williams (all Multiple Sclerosis). Sir Laurence Olivier (dermatomyositis). Robin Williams (Lewy-Body disease). Dudley Moore (Progressive Supranuclear Palsy).

Let’s move to Amyotrophic Lateral Sclerosis, AKA Lou Gehrig’s disease or Motor Neuron Disease. This is probably the most dreaded disease in all of medicine. Obviously, Lou Gehrig and Stephen Hawking are the most well-known, but here are some other names: Mao Zedong. Catfish Hunter. David Niven. Stephen Hillenburg (creator of SpongeBob).

Epilepsy, while not usually fatal, can still have an impact on one’s life. Believed to be something to ashamed of for years, many places used to have laws on the books forbidding people with seizures from marrying or having kids. Here goes: Hugo Weaving. SCOTUS Chief Justice John Roberts. Bud Abbott. Vladimir Lenin. Neil Young. Lindsey Buckingham. Lil Wayne. Former U.S congressman Tony Coelho. Prince. Florence Griffith Joyner. Fyodor Dostoevsky. POTUS James Madison.

This list, of course, only covers famous people I’ve affected. There are far more who aren’t famous, but who are just as important. Somebody’s parent, grandparent, child, spouse, aunt, uncle, cousin, friend, co-worker, and many others. If I’ve touched them, then I’ve touched you. And you probably still remember both of us.

Years ago, I first met Dr. Grumpy when he switched from internal medicine to neurology, and I remember him telling me that it was a real shock. Back in medicine he saw mostly old people sick and dying, but in neurology it had shifted to younger folks. That discrepancy still bothers him after more than 20 years of doing this job. And it always will. He has me to thank for that.

So don’t go around making me a political, religious, age, cultural, racial, national, or whatever issue. I don’t give a crap about any of those things. I’m a human issue. If you think you’re special, and have done something that will guarantee I leave you alone, you’re wrong.

Seriously bad things, like me, can happen to you. Or anyone. Sometimes it’s just shit luck.

You don’t like that? There’s only one thing you can do. If you have some cash you don’t know what to do with, donate it to a reputable organization working to eradicate one of the diseases I’ve mentioned. Because research leads to knowledge, which leads to treatment. That’s the only way you may be able to get ahead of me.

'Cause I'm in need of some restraint.

Wednesday, August 1, 2018

Monday night, 11:18 p.m.

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

Mr. Vasculopath: "Hi, you were my neurologist at the hospital last week, when I had a stroke."

Dr. Grumpy: "Yes, what's up?"

Mr. Vasculopath: "Well, I'm really worried. You prescribed Otquoobo to keep me from having another stroke, and I read about it on AllDrugsArePoison.com. It says it's really dangerous, and so I haven't started it, and now I'm worried I'm going to have another stroke, and I got all upset."

Dr. Grumpy: "Okay, let's talk about it. Are you okay right now?"

Mr. Vasculopath: "Yeah, I'm better. I just smoked a pack of cigs to calm down."

Monday, July 30, 2018

"Hey, what's that smell?"

Seen in a chart:


Wednesday, July 25, 2018

Mary's desk

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

Lady: "Hi, I need to make an appointment with Dr. Grumpy."

Mary: "Sure. What will you be coming in for?"

Lady: "I've been falling a lot - I fell today, actually - and want to get my balance checked out."

Mary: "Okay. Our next opening is Tuesday, at 3:45, then Thursday at 9:00. We also..."

Lady: "Oh, I'll need farther out then that."

Mary: "Any idea when? Like a week, or..."

Lady: "Not sure. I mean, I broke my leg when I fell today. I'm in ER, being admitted to the hospital right now. I'm supposed to have surgery tomorrow morning, so I'll be here for a few days, and then they say I'll need to go to rehab for a couple weeks."

Mary: "Why don't you just call back when you know when you'll be able to come in?"

Lady: "Am I allowed to do that?"

Mary: "Of course."

Lady: "That's a better idea. I'll do that, then."

Monday, July 23, 2018

Weekend on call

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

Nurse: "Hi, this is Susan. I'm a nurse on the 7th floor, calling in a consult on room 7147."

Dr. Grumpy: "Sure. What's the story?"

Nurse: "He's a 22 year old who took LSD a few hours ago, in the park next to the hospital, and has since been really confused. His friends brought him to ER. Dr. Newgrad wanted neurology to see him for the confusion."

Pause

Dr. Grumpy: "Are you shitting me?"

Nurse (laughing): "I wish. I tried to talk Dr. Newgrad out of the consult, and suggested we just put on some Grateful Dead in there until it wore off."

Friday, July 20, 2018

It's a guy thing

Seen in a chart:


Tuesday, July 17, 2018

Birthday gifts

One of Dr. Pissy's staff has a delightful 2 1/2 year old girl named Rachel.

This summer, due to her babysitter being on a family vacation, Rachel is at the office most days. I'm sure this irritates some people, but at our little dumpster fire of an office, we don't care. She's fun and adorable, and is a pleasant distraction from the everyday routine of medicine.

Currently Rachel is in a phase where EVERYTHING is related to her birthday, even things that are not. For example:

Dr. Pissy: "Those are nice shoes, Rachel."
Rachel: "I got them for my birthday."
 
Dr. Grumpy: "Is that a good corn dog, Rachel?"
Rachel: "Yes. I got it for my birthday."

Random Patient: "Is that a horse you're drawing a picture of, Rachel?"
Rachel: "It's for my birthday."

(for the record, Rachel's birthday is somewhere around Christmas)

Yesterday, I was getting ready to leave and went to get my briefcase. For some reason Rachel followed me down the hall, and I didn't hear her behind me.

I picked up my briefcase, turned around, and WHACK! my briefcase hit Rachel on the side of her forehead. It wasn't too hard, but enough to surprise and hurt her.

"WAAAAAAAAAAAAAHHHHHH!"

Her mother (and most of the front office) came charging back to see what happened. I was trying to comfort Rachel (without much success) and as soon as she saw her Mom, she ran to her.

Mom: "Rachel, did you get hurt? What happened?"
Rachel: "DR. GRUMPY HIT ME IN THE HEAD FOR MY BIRTHDAY!"

Wednesday, July 11, 2018

Helpful

Actual fax received at my office:



Monday, July 9, 2018

Annie's desk

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

Mr. Tush: "I'm really not happy about this whole situation."

Annie: "Okay, what is..."

Mr. Tush: "Now they're telling me that my insurance may not cover the colonoscopy at all, and I can't afford this, so really don't want to go ahead with it."

Annie: "I think..."

Mr. Tush: "LISTEN TO ME! I'm not done yet. This is stupid. I'd never have agreed to go ahead with the colonoscopy except the doctor told me it was needed. I'm not going to pay for this and I want to cancel the whole thing. It's crazy that you people..."

Annie: "Sir..."

Mr. Tush: "NO! YOU LISTEN FOR A CHANGE. I didn't really want the colonoscopy, and now I find out it may not be covered, and..."

Annie: "LISTEN!"

Mr. Tush: "WHAT?"

Annie: "This is Dr. Grumpy's office. He doesn't do colonoscopies. You've called the wrong office."


Pause


Mr. Tush: "Well, shit. Sorry about that."

Click

Friday, July 6, 2018

Cue the "Jeopardy" theme

Dr. Grumpy: "Do you have a medication list?"

Mr. Time: "Nope, I know everything I'm taking."

Dr. Grumpy: "Okay, what are you on?"

Mr. Time: "The first one begins with 'T' and has a lot of letters."

Wednesday, July 4, 2018

July 4, 1939




"Fans, for the past two weeks you have been reading about the bad break I got. Yet today I consider myself the luckiest man on the face of the earth. I have been in ballparks for seventeen years and have never received anything but kindness and encouragement from you fans.

Look at these grand men. Which of you wouldn’t consider it the highlight of his career just to associate with them for even one day? Sure, I’m lucky. Who wouldn’t consider it an honor to have known Jacob Ruppert? Also, the builder of baseball’s greatest empire, Ed Barrow? To have spent six years with that wonderful little fellow, Miller Huggins? Then to have spent the next nine years with that outstanding leader, that smart student of psychology, the best manager in baseball today, Joe McCarthy? Sure, I'm lucky.

When the New York Giants, a team you would give your right arm to beat, and vice versa, sends you a gift — that’s something. When everybody down to the groundskeepers and those boys in white coats remember you with trophies — that’s something. When you have a wonderful mother-in-law who takes sides with you in squabbles with her own daughter — that's something. When you have a father and a mother who work all their lives so that you can have an education and build your body — it's a blessing. When you have a wife who has been a tower of strength and shown more courage than you dreamed existed — that's the finest I know.

So I close in saying that I might have been given a bad break, but I've got an awful lot to live for. Thank you."



-Lou Gehrig, terminally ill at age 36 with ALS (aka Motor Neuron Disease), in his retirement speech. He died less than 2 years later.

This is likely the worst disease in neurology, if not all of medicine. It's been 200 years since the first published report on it, and effective treatment remains a mystery.

If you're looking for a cause to give money to, consider the ALS Association.

Friday, June 29, 2018

Random pictures

All right, time to hit the mailbag for stuff you guys have sent in.


First we have this delightful hand lotion:






Then we have this playground equipment, apparently designed prior to Copernicus, or the discovery of the sun for that matter:







Here's a "trending" news item, apparently created by a random word generator in Wisconsin:







Here's a mystery question that a reader says was part of her on-line medical license renewal:




Then there was this guide to grilling that could have used an extra word:


Wednesday, June 27, 2018

Seen in a chart


Monday, June 25, 2018

The Master





In the 1980's Mojo Nixon claimed "Elvis is Everywhere." While anyone who visits Vegas might concur, I have to disagree.

Here, at Grumpy Neurology, Yoda is everywhere.

Sure, he may be in many disguises, but even a Jedi Master can't hide that characteristic language pattern from a trained DoC* like me.

The following are quotes I've encountered:

From patients:

"Twenty-one headaches I had in May. Many migraines that is."

"Make the seizures stop, can you?"

"I tried to talk, but speech-wise, I could not." 

"Much pain my back does have."

"Forgot you also this, Topamax, work it did not."


In an MRI report:

"Nothing abnormal does the MRI show."


From a nurse:

"Ativan received at 8:00, she did."


From a drug rep:

"Reduction in pain they will have, yes."


From my secretary:

"3:15 tomorrow his appointment is."


And (my favorite) was this patient interaction:

Dr. Grumpy: "You really need to stop overusing Excedrin."

Lady Rebound: "It's hard, but I'll try."

Mr. Rebound: "No! Do... or do not. There is no try."


*Disciple of Charcot

Wednesday, June 20, 2018

Blood pressure and other things

Mrs. Methodical: "My blood pressures have been good, too."

Dr. Grumpy: "I'm glad. What have they been running?"

Mrs. Methodical: "I have a list in my purse. Would you like to see it?"

Dr. Grumpy: "Certainly."

She rummaged in her purse for a minute, then handed me this:


Monday, June 18, 2018

GAAAAAHHHHH!!!

Dr. Grumpy: "Any side effects with the new pill?"

Mr. P: "Only one, it makes my urine smell like something terrible."

Dr. Grumpy: "Okay and what about..."

Mr. P: "I brought some, in case you want to smell it."

Pulls Tupperware container out of bag.

Monday, May 28, 2018

That's a wrap, folks

With the school year down to it's final 2 weeks, I'm shutting down the blog until the shouting here is over. Too much band stuff, year-end competitions, parties, and other stuff to deal with, besides my day job.

See you in a few weeks!

Friday, May 25, 2018

Texting with Frank

Mrs. Grumpy asked me to deal with dinner. Not knowing what the food status was at home, I made the mistake of asking Frank for help.




Some days... Sigh.

Wednesday, May 23, 2018

Phone

Mrs. Whiney was not happy.

She'd shown up 45 minutes late for her new patient appointment with no other explanation than "I have other things to do too, you know!"

Now she was not accepting that I wasn't going to see her and she'd have to reschedule for the next available slot, 2 weeks from now (and I thought I was being nice by letting her do that).

She'd berated Pissy's staff, who'd gotten Mary.

She'd been chewing out Mary, who'd finally walked away from the window and called me out from a patient room.

She was absolutely stunned when I told her I agreed with Mary, and she wasn't going to be seen today.

In an attempt to get me to give in she menacingly said "I. Want. You. To. Know. That. I'm. Calling. Dr. Stevens. And. Telling. Him. You. Treat. His. Patients. Like. This."

I smiled and wished her a good day. She pulled out her phone, knocked on the window, and asked if we could give her Dr. Steven's phone number. We ignored her.

Now it was time for her to make a scene for the rest of the lobby. And she made the critical mistake of getting her phone involved.


Mrs. Whiney: "Siri! Call Dr. Stevens!”

Siri: “There is no Dr. Stevens in your contact list.”

Mrs. Whiney: “SIRI! CALL DR. STEVENS RIGHT NOW!”

Siri: “Now playing 'Right Here Right Now' by Jesus Jones." (music starts)


Some elderly guy in my lobby and the drug rep he's never met before next to him start holding each other to keep from cracking up.


Mrs. Whiney: “SIRI! STOP THIS SONG AND CALL DR. STEVENS!”

Siri: “There is a chiropractor 1/2 mile north of you. Would you like directions?"


Drug rep starts snorting loudly and runs out of office, mumbling something about allergies.


Mrs. Whiney: “SIRI! CALL DR. STEVENS!”

Siri: “I found 3 pharmacies within two miles. Would you like me to call one of them?"


Mrs. Whiney throws her phone on the ground, picks it up, shoves it in her purse and yells "IT"S NOT FUNNY!" She storms out.

A few seconds passed before everyone in the office and lobby completely lost it and became hysterical. Including the patient who'd wandered out of my office to see why I hadn't returned.

Monday, May 21, 2018

Thrift

Dr. Grumpy: "How's the new medication working out for you?"

Mr. Pill: "Terrible! I'm nauseous all the time, have headaches, and throw up a lot!"

Dr. Grumpy: "Then let's stop it and..."

Mr. Pill: "I don't want to do that! I just bought a 90 day supply!"

Thursday, May 17, 2018

Surprise!

As the school year begins wrapping up, we're moving into the next phase of the Wingnut High School marching band schedule: preparing for next season's football halftime show.

Yeah, you read that right. The next high school football season starts in 3-4 months, and so the twins and their friends are already working on the show.

So yesterday a flyer was sent home with the twins, listing all the stuff. Band camp dates. Meetings over the summer to start working on props. The theme of the show. Where to find the music to practice. Marching formations. Color guard maneuvers. Incoming freshmen orientation. Yadda yadda yadda.

About halfway down the page Mrs. Grumpy and I were surprised to find a paragraph that said “Practice marching sessions for the new steps and formations will be June 19, 25, and 29, July 7, 14, and 22, and August 12, 18, and 22. These will be held at Craig Grumpy’s house from 10 a.m. to 2 p.m. Bring your own water bottle. Lunch will be provided.”




CRAIG!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Monday, May 14, 2018

Coffee

Dr. Grumpy: "Are you much of a drinker?"

Mr. Collins: "Nope. Not at all. Just coffee, but I admit I'm a caffeine junkie. I drink it all day."

Mrs. Collins: "What are you talking about? You put Baileys in your coffee all day! You even keep it in that little thermos you sneak to work!"

Mr. Collins: "That doesn't count!"

Wednesday, May 9, 2018

Seen in a chart

Remember medical students: taking a good family history now includes covering test conclusions, free text, and practice management, but fortunately not retardation or cancer.



Monday, May 7, 2018

Random pictures

Okay, time to hit the mailbag for stuff you guys have sent in.


First, taken in a subway, is this opportunity that could end unemployment:

 





Here's this headline, which is just begging for someone to snicker at it.






Then there's this refrigerator drawer in a reader's recent appliance purchase, which sounds somewhat obscene:






 Here's a coffee pot seen early one morning at a hospital nurses station:





That's an interesting name for your iPhone:





And, finally, this box label. Which seems awfully pretentious for a freakin' cantaloupe.



Friday, May 4, 2018

Early

Guy comes in, stands at counter.

Mary: "Can I help you, sir?"

Guy: "Uh, I think I'm early for my visit."

Mary: "Okay. What time is your appointment?"

Guy: "I don't have one."

Wednesday, May 2, 2018

Great moments with Amazon

From the "now they definitely won't fall out" department.



Thank you, T!

Monday, April 30, 2018

Monday Reruns

Okay, everybody, let's take the Way-Back Machine to the early 1990's, when 4th year medical student Dr. Grumpy is interviewing for residency.


After medical school, young docklings go off to residency in our chosen fields.

But before we get into residency (through a mysterious process called "the match") we go off on interviews. Just like any other job.

I did my share of these interviews, traveling to 7 neurology programs in the early 90's to peddle my wares. These aren't quite as stressful as medical school interviews (for those you're begging them to take you, while for residency they need you & you need them, so both sides are trying in impress each other).

And this is the story of my least impressive interview:

I'd flown into the city the night before, and spent a relaxing night at a Motel 6.

The interview instructions said I was to begin by attending the Shitzenfuk Hospital Neurology conference at 7:30 a.m. This was several miles from the residency program's main hospital. And they actually told me to "ask around when you get there, and find a doctor willing to drive you back to our offices after the meeting".

So I took a cab from my motel to the hospital, and found the auditorium. Here I am, in a strange city, dragging my overnight bag around, with a bunch of docs who I don't know and who don't know me, and I'm walking around trying to bum a ride. Finally, after several looked at me like I was a sexual predator, one finally said. "Okay, I'm heading that way. I guess I can give you a ride."

Guess what? He turned out to be the freakin' chairman of the program I was interviewing at! He'd signed the letter telling me to bum a ride. You'd think he could have offered initially, since he knew I'd be there, but no.

So we walk out to his car. Mind you, I'm not a car snob. I don't expect doctors to be driving expensive things (my own car is a 2000 Nissan), but nothing could have prepared me for Dr. Chairman's mean set of wheels.

It was an early 70's Japanese something. Missing the right front fender. The trunk was half open, held down by a bungee cord threaded through a rust-hole.

I opened the passenger door. And a pile of empty soda cans, newspapers, fast food containers, orange peels, and heaven knows what else, fell out. Dr. Chairman said "sorry, let me clear that off" and began chucking the pile of garbage into the back seat (which was already covered with trash).

And off we went. It was December, and cold. My window was open. I tried rolling it up, but he said, "there's no window there, it broke years ago." The heat didn't work, either. So I was shivering away, with my overnight bag on my lap (no space for it anywhere else in the car). I hoped his driving skills were better than his car-care talents, because my seatbelt didn't work.

So we got to Neurology HQ. Where Ms. Bitchy at the desk (Dr. Chairman abandoned me as soon as we walked in) claimed I hadn't been invited for an interview, even when I showed her my letter. Eventually she realized she was looking at the previous week's schedule, and blamed me for having handed her the wrong schedule (which she'd actually pulled out of her desk).

Then it was time for my tour of the esteemed facilities. Ms. Bitchy directed me down a hall, and told me someone would meet me there.

Fortunately, one did. It was a nice guy named Pete, who (allegedly) was the chief resident. We talked for a minute in the middle of the building's lobby, which had white pillars everywhere, and halls leading in different directions.

After giving me a brief summary of the areas we'd be going to, Pete said, "It's a beautiful hospital. Follow me." He then turned around and walked straight into a pillar, breaking his glasses.

I helped Pete up, while some other guys in white coats ran over to try and stop the blood now pouring out of his nose.

As they led him away, Pete told me to wait in the lobby. A few minutes later Ms. Bitchy showed up, leading a girl in scrubs who'd apparently been on call the night before, and looked (understandably) less then enthusiastic about showing me around. It was a pretty quick tour.

Afterwards I had an interview with a doctor, who used most of our interview time to return patient calls. He also called Mastercard to argue about some charges, which he blamed on his ex-wife.

Then it was (per the schedule) lunch with the residents. None showed up. It was me and 3 attending physicians. Ms. Bitchy, the secretary-from-hell, had only ordered 3 lunches. She gave one to each of the doctors, and told me where I could find the hospital cafeteria.

I just went hungry, and spoke to the doctors. One of them told me he thought the newfangled MRA technology was a passing fad.

Then it was another interview. This time with Dr. Chairman of the crappy car. Who'd inexplicably left for the day. No one knew where he'd gone, or why.

Thus ended the interview. Ms. Bitchy told me she'd arrange a ride for me back to the airport, but given her remarkable organizational skills displayed thus far, I declined. She wouldn't let me use the phone on her desk, so I found a pay phone and called a cab.

I ranked them last. I have no idea where they ranked me. And no, I didn't go there.

Thursday, April 26, 2018

Memories...



In the early 80's my family went on a generic “American Family Goes on a Bus Tour of Europe” trip. My sister and I (both teens) shared a hotel room.

My mom, for some reason I don’t remember (perhaps I never knew) had packed a bunch of off-brand blueberry Pop-Tarts. They weren’t even the real thing, some cheap store generic. Maybe she thought they didn’t have food in Europe. So this box of suckish store-brand pop-tarts was tossed in a suitcase, flown across the Atlantic on a 747, dragged over land in a tour bus, and taken across the channel in a hovercraft (yeah, there was no Chunnel, youngsters). For the record I think it was stale long before we even left. Possibly before she bought it. Why it made the trip I still don't know.

Anyway, late one night in Paris, while watching the crappy hotel room TV and trying to guess what they were saying, my sister and I had a big fight over something. I don’t remember what. It escalated from shouting to throwing things... and the nearest things at hand were the pop-tarts.

As we hurled them back & forth the silver packages tore and opened, sending chunks of pop-tarts  flying everywhere. If a piece was big enough to throw, it was thrown. I think we also threw some rock-hard raisin buns leftover from breakfast, hotel stationary, pens, and anything else lying around.

When it was over there were stale crumbs, frosting, and streaks of nasty artificial blueberry filling EVERYWHERE. Walls, blankets, sheets, curtains, TV, mirror, me, sister, door, carpet.

We checked out in the morning to move on to whatever the next country was. I have no idea what the place's cleaning crew thought of the bizarre mess.

My sister and I were terrified Dad would chew us out about extra charges for damages, but it never happened.

Monday, April 23, 2018

Time

Got this inquiry in a research email:




Not sure what sort of range they're really looking for, but curious where they came up with the higher end. If you're seeing 100,000 patients with ANYTHING in a 31 day month, it means you're spending 27 seconds with each of them. Provided, of course, that you don't stop to eat, sleep, or hit the bathroom.


"Hello, I'm your doctor. Have a nice day."




Friday, April 20, 2018

Seen in a chart


- Thank you, KC!

Wednesday, April 18, 2018

Turing test



Guy in suit comes in and stands at the front. Mary was tied up on the phone, and Pissy's staff had run out to pick up lunch. So I walked over to deal with him.

Dr. Grumpy: "Hi, can I help you?"

Suit guy: "HI! I'm your rep for the all-new Ginsu surgery center! Are YOU" (points finger at me) "Dr. Grumpy?"

Dr. Grumpy: "Uh, yeah, but I don't do..."

Suit guy: "I'm here to get YOU, Dr. Grumpy" (points finger at me) "to start doing YOUR outpatient procedures at the all-new Ginsu surgery center! What kind of outpatient surgical procedures do you do that we can help YOU, Dr. Grumpy" (points finger at me) "with?"

Dr. Grumpy: "None, actually, I'm a neurologist and..."

Suit guy: "Of course you do! ALL doctors have procedures! Which ones do YOU, Dr. Grumpy" (points finger at me) "do?"


(I look around. I'm alone. I hear Mary, with Pissy's returned secretary, out in the hall trying not to crack up in hysterics)


Dr. Grumpy: "EEG's. But those aren't..."

Suit guy: "We don't do THOSE at the all-new Ginsu surgery center, but we can help YOU, Dr. Grumpy" (points finger at me) "achieve better results on your outpatient laparoscopic appendectomies, gall bladder removals, and orthopedic arthroscopies. Why don't YOU, Dr. Grumpy" (points finger at me) "give the all-new Ginsu surgery center a try? I bet YOU, Dr. Grumpy" (points finger at me) "would be pleasantly surprised at what we can do for YOU, Dr. Grumpy" (points finger at me) "and your patients!"

Dr. Grumpy: "Look, I'm sorry. I don't mean to be rude, but you're wasting your time here. I'm a neurologist. I don't do surgery of any kind."


Long pause


Suit guy: "None at all?"

Dr. Grumpy: "Zero. Nada. Zilch."

Suit guy: "Okay, so what do you, um, Dr. Grumpy" (sort-of points finger at me) "as a, uh neurologist doctor do, exactly?"

Dr. Grumpy: "I sit at a desk all day and try to look smart."


Longer pause


Suit guy: "Um, I mean... uh..."


He left.

Monday, April 16, 2018

Breaking news!

From around the globe, Dr. Grumpy's crack team of reporters brings you the stories that shape your world.



DATELINE: FLORIDA: Xavier Moran was in a car accident, and told police that his dashboard camera could prove he was cut off by another driver. To prove it he turned the camera over to police and signed a waiver allowing them to search the data file.

Unfortunately, the same camera also had footage of Mr. Moran using a baseball bat to burglarize a beauty supply store a few hours prior to his accident.

He was arrested for the burglary. No word yet on whether someone really did cut him off in traffic.



DATELINE: NEW YORK: Police were mobilized last Thursday after someone reported an escaped tiger running loose in Manhattan.

Investigating officers found it was actually a racoon.

A local news reporter suggested the caller visit a zoo to learn the difference.

The racoon has been turned over to the ASPCA.




DATELINE: not sure, somewhere in the U.S.

A reader sent in this pic of an, uh, innovative way to replace a broken rear window:




Friday, April 13, 2018

Special

Now I really feel valued. Thanks, Medscape!




Thank you, CU!

Wednesday, April 11, 2018

Teenage boys

Craig texted me after his zoology/botany class.



Monday, April 9, 2018

Mary's desk

Lady comes in, stands at counter.

Mary: "Hi, can I help you?"

Lady: "I'm here for my blood draw."

Mary: "We don't do labs draws here... Are you one of Dr. Grumpy's patients?"

Lady: "No, I'm enrolled in the research study, and was told I needed to have my blood drawn."

Mary: "Oh, okay. You're looking for the research center. They're 2 doors down the hall. Just go out  and take a left."

Lady: "You know, you people don't make it very easy to participate in your studies. I mean, I drove all the way here from south Grumpyville, and now you're refusing to draw my labs."

Mary: "You're not in the right office for that, ma'am. It's 2 doors down the hall, on your left. They have a big sign that says "Medical Research."

Lady: "Who is in charge here?"

Mary: "Uh, Dr. Grumpy."

Lady: "I want you to know I'm reporting your unhelpful attitude to him. Getting here on time wasn't easy."

Mary: "But..."

Lady: "Have a nice day."

Walks out.

Friday, April 6, 2018

Majority rules

Dr. Grumpy: "Any other questions?"

Mrs. Kroger: "I just can't believe you don't think I have Parkinson's disease! They all said I did!"

Dr. Grumpy: "Who's 'they?' Your other doctors?"

Mrs. Kroger: "No, the cashiers over at Grocery World."

Wednesday, April 4, 2018

Helpful

Seen on an office intake form.



Monday, April 2, 2018

House hunting

Mr. Patient and his wife come in. She's staring intently at something on her phone.

Dr. Grumpy: "Hi, folks. Have a seat.  How you been doing, sir?"

Mr. Patient: "Better, that medicine has really helped a lot and..."

Mrs. Patient "Mike, what do you think of the kitchen?" (shows him phone)

Mr. Patient: "Looks fine to me."

Mrs. Patient "I think it's too small."

Voice from phone: "Ma, you'll get used to it. You guys go out for dinner every night, anyway."

Dr. Grumpy: "Um, what's going on?"

Mrs. Patient: "We're thinking of moving to San Diego, and our son is showing us places he's looking at for us on Facetime."

Dr. Grumpy: "So about the new medication, have you had any side effects?"

Mr. Patient: "No, actually I've been... Steven, is that the garage? I need more space than that for my woodworking stuff."

Mrs. Patient: "It's not like you ever use it. I was going to donate it to charity rather than drag it cross country."

Mr. Patient: "The hell you will! I use it more than you use the kitchen."

Voice from phone: "Dad, be reasonable."

Mrs. Patient: "Your father is never reasonable. Haven't you learned that? Mike, answer the doctor's question."

Mr. Patient: "I forgot what it was."

Dr. Grumpy: "Any side effects?"

Mr. Patient: "No. Steven, is there a community pool?"

Monday, March 26, 2018

Spring break

My kids are off from school this week, so heading west to visit family and avoid snow.

In the interim, I leave you this thought.

When all we see in the news is the capacity of the human brain at it's worst (insane politicians, terrorists, and people with machine guns massacring school kids), it's easy to forget that same brain is also capable of things that are good, innovative, and entertaining.

Here's the Brazilian comedy team Barbixas. No knowledge of Portuguese is required.


Friday, March 23, 2018

Breaking news!

From around the globe, Dr. Grumpy's crack reporters bring you the stories that shape our world.


DATELINE: MINNESOTA

A teenage girl failed her driving test in spectacular fashion this week.


Photo: Buffalo, MN Police Department.

At the beginning of her driver's license behind-the-wheel exam, she put the test car into drive instead of reverse, jumping onto the sidewalk and plowing through the front of the building.

The same building where the office to take the driving exam was located.

No one, fortunately, was seriously injured.



DATELINE: DELAWARE

Christopher McDowell walked into the local police headquarters and asked if someone could give him a ride home.

Police officers quickly noticed that Mr. McDowell was:

1. Drunk (at least he wasn't driving, though. Good boy!)
2. The guy who was wanted for shoplifting and fraudulent returns at Kohl's.

He was taken into custody, charged with shoplifting, and released on bond.

Afterwards he was allowed to call for a ride home, and contacted his friend April Wright.

When she arrived to pick him up, police noticed Ms. Wright was the other person wanted for the same shoplifting crime at Kohl's.

She was then also arrested, charged with shoplifting, and released on bond.

The article doesn't say if she got to drive them both home afterwards.



DATELINE: COLORADO

Visitors to The Dinosaur Experience got more than their money's worth when the attraction's animatronic Tyrannosaurus Rex suddenly burst into flames.



Photo: Royal Gorge Dinosaur Experience.

 
When the fire, caused by an electrical short, started it appeared Mr. Rex had suddenly become Godzilla and was breathing fire. It quickly became apparent that something more was afoot.

The blaze was safely contained, and no one was injured. The owners report that a new Tyrannosaurus should be ready by summer.




DATELINE: FLORIDA

Two men were arrested following the burglary of a home. They tried to cover up the crime by burning down the house with Ragu-brand tomato sauce.

The owner of the home received a text that his alarm had gone off while he was at work, and called police.

Officers arrested the two men at the scene. They'd left a pot of the pasta sauce on the stove with a washcloth, hoping to burn down the house and make it look like an accidental fire.

Besides stolen items, the men also had an empty jar of Ragu in their car.

For unknown reasons, one of the suspects was wearing a bull-costume onesie when arrested.

Wednesday, March 21, 2018

Wednesday re-runs

Lunch today was from a new drug rep, pushing a sleeping pill.

She made the MAJOR mistake of rudely talking down to the office staff, letting them know they are peons, and that she only deals with doctors. This pisses me off, and even worse, it pisses them off.

Anyway, her sleeping pill's claim to fame is that patients who take it get an average of 7.8 hours of sleep. As a result, they have little pamphlets with this fact, and the rep had a big button on her jacket that said "Are your patients getting 7.8 hours every night?"

During lunch she left her jacket over the back of a chair outside our break room. While she was talking I noticed 2 of the office ladies disappear for a few minutes.

When Ms. Drugrep was leaving she put her jacket back on, and brought me an iPad to sign for samples. As I scribbled I noticed that the button on her jacket had been altered, and now said "Are your patients getting 7.8 inches every night?"

She has no clue, either. And I'll probably never find out what happens.

Monday, March 19, 2018

Annie's desk

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

Mr. Car: "Hi, I see Dr. Grumpy, and I just got a letter from the MVD that they're going to revoke my driver's license unless my neurologist fills out a form."

Annie: "Okay, why don't you make an appointment and bring it in. Let me transfer you to Mary... You know, it looks like you were last here about 7 years ago, and sent us a letter to release your records to a doctor across the country?"

Mr. Car: "Yeah, I moved here 7 years ago."

Annie: "So are you back now?"

Mr. Car: "No, I still live here in Faraway state. It's their MVD that sent me this form."

Annie: "Well, Dr. Grumpy can't fill out forms on someone he hasn't seen in 7 years. For that matter, I'm not even sure if he can do them for a state he doesn't have a medical license in. Did you ever see a neurologist there?"

Mr. Car: "Of course. But the copay to see him is $40, and I haven't seen him in about a year, and he wanted me to come in to get it done and get my refills and all, so I thought Dr. Grumpy would do it for free."

Annie: "No, he'd have to see you in person after this much time, and if you're on the other side of the country you'd be better off..."

Mr. Car: "But I don't want to pay the $40 for some bullshit paperwork! Can't Dr. Grumpy call my doctor here and ask him to waive the copay?"

Annie: "No, he's not going to do that. Unless you're going to come back and see Dr. Grumpy, this is between you and your neurologist there."

Mr. Car: "Can you call around Faraway and see if you can find someone who'll see me for free? I really don't have time to waste on this."

Thursday, March 15, 2018

Artisinal mailbag

All right, here's some more artisanal bullshit you guys have sent in.


If you feed your cow artisanal grass, what comes out the other end?





Very few chains are as ubiquitous and generic in America as Walgreen's, and yet they apparently carry artisanal stuff. Which I'm pretty sure was "handmade" by a machine in southeast Asia.

"How stylish can you get?"



Making toast is right up there with boiling water and putting chips in a bowl as far as culinary skills go, but apparently you can now take your "putting bread in a toaster and pushing down in the handle" skills to a whole new level for only $24.95 with...






Even videogames are now into it:






At this point I'm ready for a drink





Butt you just knew someone would sell this:

Order it with the toast book and make Scotch Woodcock!

Monday, March 12, 2018

Shopping

I have a pretty good rapport with my patients, tossing jokes and mild insults back and forth during a visit. It's just part of the way I practice. Most of them like it, since it flies both ways. Patients that don't gravitate elsewhere.

But sometimes it has its consequences.

One of them, Ted, is an older fellow who works weekends at Costco, running sample stations. When he shows up they tell him where he'll be working that day. He briefly reads up on the product and sets up a table.

Yesterday, as I picked up some items to feed the teenage horde, I saw him at a table over by the pharmacy and waved.

He yelled "HEY, DOC! I'M SAMPLING ADULT DIAPERS TODAY! GOTTA LEAKY BLADDER? COME ON OVER HERE AND TAKE ONE!"

And he waved a free sample in the air at me.

My kids (and everyone else nearby) cracked up.

I yelled back "Ted, you're a dead man!"


Friday, March 9, 2018

Breaking news!

From around the globe, Dr. Grumpy's crack reporters bring you the stories that shape our world.

DATELINE: ARIZONA

A man and woman fleeing police officers attempted to escape by climbing a fence into a parking lot.

Unfortunately for them, the lot they chose was the secure one for the local police station, where several officers were conducting a training exercise.

Video surveillance shows the subjects somehow missing a large sign on the fence that said "POLICE DEPARTMENT."

Both were taken into custody.



DATELINE: TEXAS

From the "Bitcoin is so 2017" files...

In a sticky situation involving political donations, a local candidate has received several donations in... deer semen.

Yeah, you read that right. Frozen straws of deer jizz are worth big bucks, and are being sold and auctioned off at fundraisers. How you might explain coming home with frozen deer cum, as opposed to a cap with a political slogan on it, to your spouse is beyond me.

An attorney they interviewed for the story is named, I swear, Buck Wood.

Regrettably, the recipient of the donations isn't named Jane Doe, or even Bambi.




And here are some other interesting things seen in the news recently:

From the "who wrote the headline?" department:





Next, from the "I failed zoology" office:





And finally, we can only say, "I bet he did."



Wednesday, March 7, 2018

Mary's desk

Mary: "Hi, can I help you?"

Mrs. Lost: "Hi, I have an appointment with Dr. Grumpy, but I think I'm in the wrong suite."

Mary: "No, you're in the right place. Let me get you some forms..."

Mrs. Lost: "But Dr. Grumpy is in suite 608."

Mary: "This is suite 608. You found us! So if you can fill out..."

Mrs. Lost: "This isn't suite 608. It's 407."

Mary: "No, it's 608. You can see it on the door there."

Mrs. Lost: "When did you move to 407?"

Mary: "We didn't. Can I get a copy of your insurance card?"

Mrs. Lost: "Coming to the doctor is so confusing."

Monday, March 5, 2018

Skool Nerse Time

This is Mrs. Grumpy

This past weekend I somehow got dragged into chaperoning a school band competition, which involved a long school bus ride each way. The heavy snow didn't help, slowing the drive down to about twice what was expected.

I kept asking the band director if we could give up and go back, but she just laughed and said "the show must go on." As I stared at passing snow drifts out the window I wanted to throw her in them and let her walk.

Anyway, due to the unusually long drive we made an unplanned stop on the way home so everyone could use a restroom and get something to eat. Fortunately, America is full of generic shopping malls with a wide variety of stores and fast food places. So all of you disappeared for 20 minutes, which was fine with me, as I got some peace and quiet until you returned for the last 2-3 hours of the drive.

You guys were pretty quiet for the last leg, no doubt because of the effects of cheeseburgers and fries hurriedly crammed down at McWhatever's. Because of the silence I began to doze off myself. The band director, wired on her 28th cup of coffee of the day, was on her iPad maniacally working on next weekend's competition.

It was actually pretty relaxing until the screaming began in the back of the bus, and rapidly spread. I thought perhaps Freddy Krueger had climbed in through a window and was attacking the clarinet section. The bus driver almost crashed as he hurriedly pulled off the road and we all frantically piled out into the snow, terrified of, well, whatever had happened to set you all shrieking hysterically.

After the bus had been abandoned we got a clearer idea of the emergency.

Apparently a few creative souls, whose names we don't know at this time, had wandered over to House O' Reptiles and bought a paper bag FULL of crickets meant to be used for feeding lizards, and released them in the back of the school bus. This resulted in the mass panic.

A kindly police officer pulled over to see what the problem was. When told he climbed on the bus himself to see, and then began laughing hysterically. Our driver channeled his best Samuel L. Jackson and yelled "I've had it with all these.... crickets on this... bus!" (not quite in Mr. Jackson's original creative words).

With the snow coming down, and temperatures below freezing, and being 2 hours from home... we didn't have many choices. We all got back on the bus.

Usually there are a few couples in the back of the bus trying to make out, and I'm supposed to keep an eye on you. I must say, having a large numbers of arthropods crawling all over certainly put the kibosh on your hormones during the ride back.

Fortunately, that was my last chaperone job of the year.

Craig and Marie have asked me to buy them each a can of Raid to take on the next road trip.

The district has charged the band boosters an extra $75 for fumigation services.

Thursday, March 1, 2018

Seen in a chart


Monday, February 26, 2018

Alone

Over the course of a career you see a lot of patients. I'd guess, based on looking through my charts, roughly 30,000-40,000 to date.

Most, especially the ones from the very beginning, are long forgotten. Sometimes I'll request old hospital records on someone from a place where I did a rotation and am surprised to see a note from a younger version of myself. And I have no recollection of them at all.

But a handful never leave you. Some because you learned a lot from them. Others because of a shared interest you chatted with them about. And a few because they struck a chord that's never gone away.

I was at the tail end of my intern year, doing a mandatory ICU rotation, when they brought him in. I don't remember his name now, mainly because I never knew it then, either.

He was a homeless man, who'd fallen asleep in a trash dumpster. In the dark early morning no one saw him fall into the back of a garbage truck when the container was emptied. With the noise of the engine no one heard his screaming as he was mashed by the machinery. When the truck was emptied a few hours later sanitation employees called 911.

He was still alive - barely - when we got him. Massive blood loss and multi-system trauma. Broken bones, ruptured viscera, missing pieces of limbs. Teams of doctors paraded in & out of the room trying to save him. As an intern I was one of them, but on the periphery of the internal medicine group.

What was left of his clothes had no ID, and he was never conscious. Social workers tried to find family, a name, anything. They combed missing person databases and made endless phone calls all over the country. Nothing really to go on, not even a tattoo. Just a 50-ish white male. Police spoke to other homeless who lived in the area. A few remembered him, but none knew his name or anything about him.

For a week in the never-ending daylight of the ICU an army of doctors, nurses, RT's, lab techs, and others did their best to keep him alive. Although his prognosis was grim, we all thought that, sooner or later, the social workers would turn up a friend, or relative, or find some lead to them. He was, after all, somebody's son. Or brother. Or father. If there was someone out there who might be able to tell us what he'd want, or even who just wanted to say goodbye to him, we'd give them that chance.

But it never happened. Roughly a week after he came in the attending doctors felt there was no hope and nothing further to be done. The machines were turned off one by one and he died quickly. Someone on the trauma service signed a brief death note and reached for the next chart. The body was taken away to an unmarked grave. I couldn't find it today if I tried.

I'm sure somewhere out there is an argument about how much money was spent on his case, and how many vaccines or school lunches or police or teacher salaries it could have paid for. Given how many cases there probably are like his, and multiply by that number... I'm sure it's a lot of dollars. But, while it has some points, that debate didn't occur to me at the time, isn't why I still remember him, and I'll leave it to other blogs to discuss.

Regardless of the circumstances of his life - I admit I'd have ignored him on the street if he'd asked me for change the day before - he died alone. Did he have any living family? Do any of them wonder what happened to him, then or now? Were they sick of whatever issues he had again and again, and had long pushed him out of their minds? Did he have a good childhood or was he always on the streets? Did he serve his country? Was he hoping to die in the dumpster or just looking for a little more shelter than the sidewalk offered that night?

Alone.

25-30 years later I can still see him as they brought him to ICU, the different teams of doctors yelling orders. For a week I'd sometimes sit at the nurses station and stare at him, wondering. Did anyone else working on the case find themselves as bothered as I was? Maybe we just all covered it up, afraid that to admit he was anything but a badly injured homeless guy would be a sign of weakness. I may be the only person today who even remembers him at all.

Alone.

The case still keeps me up at night. Thinking of him, and behind that the abject terror of the thought of someday myself, or my wife, or kids, or other loved ones or friends, being in the same situation. Alone. Impoverished with nothing. Unloved. A life and existence forgotten.

Alone.




Friday, February 23, 2018

Friday reruns

Saturday morning.


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

Miss Myelin: "Yeah, I see Dr. Cortex for my MS, and I woke up today with blurry vision, and I can barely walk."

Dr. Grumpy: "Have you had this before?"

Miss Myelin: "No, it's new. When my MS acts up Dr. Cortex usually admits me to the hospital for IV steroids."

Dr. Grumpy: "That's standard. I think you need to go to ER, and I'll likely admit you."

Miss Myelin: "Are you kidding? I don't have time for that shit."

Dr. Grumpy: "Excuse me?"

Miss Myelin "I don't have time for that. Can I schedule them for next week, like Wednesday or Thursday?"

Dr. Grumpy: "I suppose, but you'll have to call Dr. Cortex on Monday and... Look, if you're not going to let me help you, why did you even call on the weekend, anyway?"

Miss Myelin: "Because I thought it might need urgent treatment."

Wednesday, February 21, 2018

Answers

Dr. Grumpy: "So let's see what the tests show. Any other questions?"

Mrs. Cephalgia: "Doctor, how will I know if I'm having a headache?"

Pause

Dr. Grumpy: "Um, because your head, uh, hurts."

Mrs. Cephalgia: "Oh, okay... that makes sense."

Monday, February 19, 2018

Breaking news!

From around the globe, Dr. Grumpy's crack team of reporters bring you the stories that shape your world.

DATELINE: PENNSYLVANIA

Pastor George Gregory, of the Waterfront Community Christian Church, claimed that he was "counseling" a man found naked and tied up with rope in a parked car with him.

When police arrived the naked & bound man was in the front seat and Pastor Gregory was in the back "adjusting his clothes."

The good pastor states that he "did nothing" and was helping the man work through a drug problem. He also added that they “were just playing” and would “meet up from time to time to play with each other.”



DATELINE: GERMANY

Police were summoned to an apartment where cries for help were reported.

Upon breaking in, officers found 2 men "hopelessly locked together" with a mannequin dressed in a knight's costume and a remote-control toy car.

Both men were too drunk to explain exactly how this had happened, though, after being freed, one of them was charged with insulting the officers.

Inquiring minds want to know, but mercifully no pictures were taken.




DATELINE: MEDICAL NEWS

A study found that epilepsy patients who developed impaired consciousness while driving were more likely to have car accidents than epilepsy patients who retained normal consciousness behind the wheel. (Neurology Reviews, January, 2017, page 8).

Friday, February 16, 2018

"Make mine a double."

This CME course title can be interpreted in more than one way...




Thank you Dr. A!

Thursday, February 15, 2018

The answer

Thank you all for a great selection of serious, hysterical, and entertaining answers.

The correct one (as several guessed) is...

A guinea pig, viewed from above, with the owner drawing in areas where hair had fallen out (alopecia).

Congratulations to the winners! You've just won a brand new Chrysler Cordoba and you can pick it up at Morty's office!

Wednesday, February 14, 2018

Drawing

Webhill, over at Veterinarians Behaving Badly, submitted this picture. It was drawn for her by a pet's owner.





Let's have your guesses. Answer will be listed tomorrow.

Hint: It is not a turd.

Monday, February 12, 2018

Lists

I now present Mary’s list of issues that always seem to plague the last patient seen each day (especially on a Friday).


The last patient of the day:

1. Shows up late, and wants to tell you the 10 minute story of why they're late.

2. Wants to read the HIPAA privacy form word-for-word and ask questions, even though it's identical to the one every other doctor and hospital in the country use.

3. Has a new insurance card and left it at home.

4. Forgot to bring the insurance authorization for the visit, and the doctor who issued it closed early that day.

5. Left their MRI reports/lab reports/small child in the car, has to go back to get them, and has no idea where they parked.

6. Refuses to start the appointment until their spouse/child/parent arrives, and has no idea where they are.

7. Has a new address, needs to fill out the forms for it, and has to call someone to verify what it is.

8. Needs a bunch of prescriptions written, with both 30-day and 90-day scripts written for every one.

9. Shows up late, checks in, then leaves to find a bathroom and is gone another 15 minutes.

10. Somehow manages to lose their phone/sunglasses/corgi in the lobby or exam room and needs you to help them look for it.

Friday, February 9, 2018

Local insanity

Due to some unanticipated craziness here I didn't have time to write last night, so am just going to share one of my favorite TV bits:


Wednesday, February 7, 2018

Breaking news!

From around the globe, Dr. Grumpy's crack team of reporters bring you the stories that shape your world.


DATELINE: MINNESOTA

From the "hold my beer and watch this" department.

An unidentified man was injured attempting to jump a rocket-powered bike off his roof.

According to police, he'd taken a bicycle and attached skis to it, then added a motorcycle tail pipe modified into a rocket. The rocket fuel he was using in his heroic endeavor to confirm Darwinism was Heet, an antifreeze product for fuel lines.

He apparently flew off the roof, then fell 13 feet down and plowed into a fence.

When paramedics arrived he was lying on his back on a sled, pushing himself around the driveway and cursing loudly about how much pain he was in.



DATELINE: MARYLAND

Robert Meilhammer and friends were out hunting birds, and, when a flock of Canadian geese went by, one of them raised his rifle and brought a fowl down.

The dying goose, however, decided to take some primates with him, and on the way down hit Mr. Meilhammer on the head, conking him out cold, causing "head and facial injuries," and knocking out 2 teeth.

With his goose nearly cooked, paramedics took Mr. Meilhammer to an airport, where he was airlifted to a trauma center. Upon waking, he reportedly didn't remember much of the incident.

One of the goose's family members told our reporter that he hopes Mr. Meilhammer gets a large bill.



DATELINE: MINNESOTA (again)


In a sporting scandal to rival Riyadh's camel-Botoxgate, the Brainerd, Minnesota Jaycees are investigating claims of cheating at an ice-fishing tournament.

In the cut-throat, ultra-competitive, anything-goes world of ice-fishing contests, the prizes which are currently being held pending investigation are a pick-up truck, $1,000 cash, and a certificate for a free ice auger.

With over 12,000 entrants packed onto the lake like sardines, officials said screening them for fair play is enough to give anyone a haddock. Methods of cheating listed include (I swear) sneaking a live fish in with your gear or digging a shallow hole in the ice the night before, putting a live fish in it, and hoping it's still there and alive the next day.

Apparently some contestants take this quite seriously, though most were participating just for the halibut and had a whale of a time.

Thank you, Kip Addotta.




Tuesday, February 6, 2018

Feelings. Nothing more than...

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

Mrs. Visit: "Hi, I have an appointment at 2:00 today, and was wondering if I could come in at 1:30 instead."

Mary: "Sure. The slot opened up this morning, so it's all yours."



1 hour later



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

Mrs. Visit: "Hi, this is Mrs. Visit. I changed my appointment from 2:00 to 1:30, but have run into trouble. Can I still come in at 2:00?"

Mary: "Sure. It's still open. We'll see you then!"



2:15 p.m.



Mrs. Visit: "Hello?"

Mary: "Hi, this is Mary at Dr. Grumpy's office. We were expecting you at 2:00, but it's 2:15. Is everything okay?"

Mrs. Visit: "Yeah, but I have to work all day. They told me this morning that I wouldn't be able to leave at all, I guess I knew that all along. Sorry."

Mary: "Then why didn't you just cancel earlier? We can reschedule you."

Mrs. Visit: "I didn't want to hurt your feelings."

Friday, February 2, 2018

2:54 a.m.

Voice: "Hello?"

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

Voice: "Hi, this is Candy Furuncle, I see you for epilepsy? I'm on Fluximoo, I think 400mg each night?"

Dr. Grumpy: "Yes?"

Voice: "Anyway, I've got this huge boil on my left butt cheek. What am I supposed to do about it?"

Dr. Grumpy: "Call your internist. This isn't my field."

Voice: "Can you give me a hint? Like dig it out with a nail clippers or something?"

Dr. Grumpy: "No. Call your internist."

Voice: "What if he's sleeping?"

Wednesday, January 31, 2018

Checking

Dr. Grumpy: "Hi, I'm Dr. Grumpy. Have a seat. So..."

Mr. Query: "Just to make sure, you went to medical school?"

Dr. Grumpy: "Yes."

Mr. Query: "And residency?"

Dr. Grumpy: "Yes. I also did a fellowship."

Mr. Query: "Okay, thank you. My internist did medical training, so I always want to make sure the doctors she sends me to did, too."

Monday, January 29, 2018

Seen in the chart

Apparently there's a new type of cancer out there:


"Pink, some brown, reddish, too."



Oddly specific time frames:


"It's been such a long time, I think I should be going."



And, from the "you never know who you'll run into" files:



 
Locations of visitors to this page