Monday, October 8, 2018

Time out

All right, gang. I'm going to have to take a few weeks off here. We're now entering the heart of the high school marching band competition season, and between my day job and band meetings, band fundraisers, band shows, band-aids, band trips, rubber bands, and band saws I need to take some time off from the blog (and a lot of other stuff, too).

See you in a few weeks!

Thursday, October 4, 2018

Breaking news!

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


DATELINE: SANTA MARTA, COLUMBIA.

Yeimy, a married woman, and Jesus, who she'd been having a clandestine year-long affair with, decided to call Uber for a ride to a local motel they'd booked for a romantic 30 minute getaway. The helpful Uber app noted that their driver was on his way to transport them to the love nest.

Upon arriving, they piled into the back seat of his car, only to have all parties immediately realize that the driver was actually Yeimy's husband, Leonardo, who was moonlighting that night by driving for a friend.

All parties immediately exited the vehicle.

It's unknown how many stars the driver got.



DATELINE: CALIFORNIA

A group of thieves stole $18,000 worth of industrial-use GPS tracking devices from a tech company.

Upon discovering the loss, the company remotely switched them on and saw the majority of the devices were in a warehouse, while 2 were still being driving around in cars. Police had arrested all involved and recovered the devices within 6 hours.

Police also noted the thieves had drunk a few beers they'd found during the robbery. One of them cut himself in process, leaving bloody fingerprints behind as additional evidence.



DATELINE: FRANCE

From the "A horse walks into a bar" department.


Monday, October 1, 2018

Formicidae

Frank is a college freshman this year, living in a dorm. Yes, you read that correctly.

So last Thursday I'm having a typically busy day of seeing patients when a text from him crosses the top of my screen.


Frank: Dad, I need to talk to you right now. There's a big problem here.

Dr. Grumpy: I'm with a patient right now. Can it wait 15 minutes?

Frank: Yes, but hurry.

After I finished my appointment with Mrs. Freenbeen, I called Frank.

Frank: "Um, hello? Who is this?"

Dr. Grumpy: "It's Dad. You told me to call you."

Frank: "Oh, that's weird. My phone said it was a call from a doctor's office. Are you sick?"

Dr. Grumpy: "No, I'm a doctor. I work here. What's up?"

Frank: "Oh, yeah. We have an emergency. Can you, like, go to the store after work and buy, like A LOT of ant bait traps and ship them to me overnight?"

Dr. Grumpy: "What's going on?"

Frank: "Me and Mike's dorm room is, like, FULL of ants. They're everywhere."

Dr. Grumpy: "I'm pretty sure you can buy bug poison at the Target across the street from you."

Frank: "Yeah, but then I'd have to pay for it."

Sigh.

Dr. Grumpy: "Why don't you let the building people know about this? They can have your room sprayed."

Frank: "Mike said he'd do that... Hey, Mike, did you talk to the RA about the ants?"

(mumbling in background)

Frank: "Never mind, Dad. Mike says the RA told him they'd have it sprayed later today. Hey, why do you think we have all these ants?"

Dr. Grumpy: "When was the last time you guys took out the garbage?"

Frank: "Um... I don't think we have. But, like, we only moved in on what, August 27th? How often should we be taking it out?"

That was a month ago. WTF.

Dr. Grumpy: "I'd say at least every week, if not more."

Frank: "That's stupid. There's still plenty of room under our beds for stuff. We moved the empty fast food and pizza boxes all under Mike's bed last week, after we put the dirty cafeteria dishes and forks in the bathroom sink."

Urp.

Dr. Grumpy: "Those things are what are attracting the ants!"

Frank: "Really? Why would they want that stuff?"

Thursday, September 27, 2018

History reruns - September 27, 1854





After the war of 1812 , the United States and Great Britain resumed commercial trade.

On both sides of the Atlantic, businessmen competed for their share of this increasingly lucrative business. Faster ships made more money, even if it meant going full speed into bad weather and poor visibility. Many ships vanished, forever listed as overdue, and presumed lost to bad weather and icebergs.

On the Eastern side, the driving force was Samuel Cunard. In the 1840's he came to dominate the Atlantic market, with the line that to this day bears his name. The British government backed him financially, so the ships could, in the event of conflict, be requisitioned by the navy (which they often were).

On the Western side, a number of American lines tried, with varying degrees of success. The U.S. government was less inclined to become involved in these matters, and so capital was harder to raise for building ships.

As sail gave way to steam, this changed. The Americans were concerned that Cunard's steamers could be converted to warships. Faced with both real economic and feared military competition, the government began backing various companies to try and win trade back from Cunard.

The man to lead this was Edward Collins. With government subsidies he built 4 large steamships (Arctic, Pacific, Baltic, and Atlantic), bigger, faster, and more luxurious than Cunard's ships, to challenge his rival. The plan was to run a tight schedule across the Atlantic.

The Collins Line ships, with their combination of sails and paddle wheels, were some of the fastest in the world at the time. They showed the Atlantic could be crossed in the remarkable time of 10 days, and in a few cases, 9.

Backed by their respective governments, Collins' and Cunard's lines competed intensely to dominate the 3000 miles of north Atlantic. Until 12:15 p.m. on this day.

As the Arctic steamed west, through a heavy Newfoundland fog, she collided with a small French ship, the S.S. Vesta. The Vesta, although much smaller, had a hull reinforced with iron.

In the first few minutes after the collision, many of the Vesta's crew assumed their damage was fatal, and abandoned ship (against orders) to try and reach the larger Arctic. They were wrong. The crew of the Vesta worked miracles and overcame the damage.

Captain James Luce of the Arctic was a veteran of the sea. Believing his own damage to be minimal, he turned the Arctic around to aid the Vesta, and launched 2 lifeboats to help evacuate it's passengers to the Arctic.

These orders were quickly canceled when one of the lifeboats reported the severity of the damage to him. The ship was badly damaged. Like the Titanic 58 years later, he had the legally required number of lifeboats. And they weren't nearly enough to hold everyone on board.

Cape Race was 4 hours away. With his duty to his own ship clear, Luce abandoned the Vesta, heading for land. His hope was to beach the ship before she could sink.

The wreck of the Arctic over the next few hours quickly turned into a nightmarish struggle for survival, very different from the civility seen in the Titanic. Captain Luce accepted that he and his 11 year old son (who was traveling with him) were going to die, and did his best to save passengers. He was betrayed by his crew and most of his officers.

His crew disobeyed orders, commandeered the lifeboats, and fled. A trusted officer and handpicked team of seamen were placed in a lifeboat so that passengers could be lowered down to them. As soon as they reached the water they rowed away, with plenty of space in their boat.

Without lifeboats, Luce and his few remaining crew did their best. They tore the wooden deck to pieces, frantically trying to build rafts. Doors were torn from hinges to be used for flotation. All furniture made of wood was assembled on deck in hopes of saving more lives.

Of 408 who sailed, there were 86 survivors (64 crew, and 22 passengers). Not a single woman or child lived. They're remembered by a monument in Brooklyn's Green-Wood Cemetery.

Captain Luce, surprisingly, survived. He and his son went down with the ship, but were ejected from the vortex as it sank. As they swam away, a large wooden paddle wheel cover broke loose from below the sea. It launched into the air like a rocket, then came down, killing his son. And yet, at the same time, it became a makeshift lifeboat for Luce and a handful of swimmers. They were picked up after a few days by a passing ship.

The loss was a disaster, both personally and financially, for the Collins Line. Besides Luce's son, the deaths included Collins' wife and 2 of their children.

Although mostly forgotten today, the disaster dominated headlines on both sides of the Atlantic for a month, until replaced by the Crimean War. It had the same effect then as the Titanic would in 1912. Safety specialists recommended specific East-West shipping lanes. Slower speeds and loud whistles in fog. Lifeboats for everyone. The majority of the recommendations were ignored until the aftermath of the Titanic.

2 years later, in 1856, the Arctic's sister, the S.S. Pacific, vanished en route from Liverpool to New York.

It was another blow for the Collins line. There was an economic recession, and the U.S. government was now willing to let Cunard have the Atlantic. Collins' subsidies were cut, and in 1858 his line folded. The surviving ships were auctioned off.

The wreck of the Arctic hasn't been found (to my knowledge no one has looked).

The Pacific was thought to have been lost to storms or icebergs in the north Atlantic. To the surprise of everyone, she was accidentally found in 1991 in the Irish Sea, only 60 miles from where she left Liverpool. Why she sank remains a mystery.

Cunard survives to this day, though is now owned by Carnival Lines.

Government subsidies for shipping, with the ships to be used in time of war, continued into this century in all the major powers.

The last American attempt to share the Atlantic trade lies, mostly forgotten, in Philadelphia. She is the liner S.S. United States, built with subsidies after World War II. The government paid for her huge size and (even to this day) remarkable speed, with the plan of using her as a fast troop transport in future conflicts. Her commercial career, like all liners, was doomed by the passenger jet. Multiple attempts continue to be made today to save her from the scrapyard.

Tuesday, September 25, 2018

Annie's desk

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

Mrs. Haddock: "Hi, I need a refill on my medication. It also has to be authorized through my insurance, because the last auth has expired."

Annie: "Okay, I can get started on that... you know, it looks like we haven't seen you since 2010."

Mrs. Haddock: "Wow. Time flies. Anyway, I'm going on vacation tomorrow, so can you please get this taken care of?"

Annie: "We can't refill meds on someone we haven't seen in 7 years, let alone get an insurance authorization. Who's been filling it?"

Mrs. Haddock: "My internist."

Annie: "Then you'll have to call him to get this refill, and make an appointment to re-establish with Dr. Grumpy if you want us to prescribe it."

Mrs. Haddock: "I haven't seen him in 6 months. He doesn't take my insurance anymore. It's National Illness, Inc."

Annie: "We don't take that, either, so we can't get an authorization for you."

Mrs. Haddock: "But I'm leaving TOMORROW! You need to call this in and get it authorized RIGHT NOW!"

Annie: "We can't do that, like I said, we haven't seen you in 7 years, and we're not contracted with your insurance."

Mrs. Haddock: "YOU'RE RUINING MY VACATION!"

click

Friday, September 21, 2018

The teenage mind

I'm sitting at my desk, about an hour before my first victim patient. My wife is at a meeting out of town, but fortunately the kids are old enough to drive themselves to school.

Then the text came in.

Craig: Dad. I'm locked out of the car. I need help.


What the hell? School started 20 minutes ago!


Dr. Grumpy: Ask Marie for her keys.

Craig: I can't. She's at school.


WHAT?!!! Okay, this isn't making sense.


Dr. Grumpy: Then where are you?

Craig: I'm at 7-Eleven.

Dr. Grumpy: Why are you at 7-Eleven twenty minutes after school started?

 Craig: It was an emergency! I had to get something for class! Do you have keys to the 4Runner?


Sigh.


Dr. Grumpy: Yes. Which 7-Eleven are you at?

Craig: The one at South Street and Central.


So I tell Mary I'm going to rescue Craig and will be back in a few. Fortunately, South & Central isn't too far from my office.

I get to South & Central, and Craig is nowhere to be seen.


Dr. Grumpy: Craig, I'm at the 7-Eleven at South & Central, and you're not here.

Craig: Well, I'm at a 7-Eleven. Maybe it's not that one.


I roll my eyes, take out my iPhone, and look up his location.


Dr. Grumpy: Craig, you're almost 3 miles away, at the 7-Eleven at 12th St. and Elm.

Craig: How was I supposed to know that? Please hurry, I'm going to get in trouble at school!


So I head over and find him there, standing outside the car. As I unlocked it he picked up two Slurpee's in a cardboard carrier and set them on the floor.


Craig: "Thanks, Dad. I'm sorry."

Dr. Grumpy: "It happens. What did you need for school, anyway?"

Craig: "The Slurpees."

Dr. Grumpy: "You left school to get 2 Slurpees? This whole thing was over a Slurpee?"

Craig: "Slurpees. I mean, yeah, Marie wanted one, too."

Dr. Grumpy: "Why didn't you get them at the 7-11 by the school?"

Craig: "I went there first, but they don't start making them until 10:00. But I remembered there was another 7-11 down here."

And he drove off.

Monday, September 17, 2018

Random pictures

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


First we have this picture, taken at an airport, where bicycles using the bathroom is, apparently, an issue:





Then there's this place's answer to "what should we get grandma for Christmas?"

"Wow! Verapamil, metformin, morphine... this place has the best gifts!"




While we're on the subject of places to get gifts, who can forget...






Then there's this product so you can "keep balling all night."






And, finally, there's this happy-go-lucky coloring book about everyone's favorite viral-disease-of-cheerfulness, RABIES.




Sunday, September 16, 2018

Holidays are coming!

So if you'd like to send in a horrifically tasteless submission for this year's Dr. Grumpy gift guide, please do so! My email is in the right sidebar.

Thank you!

IG

Thursday, September 13, 2018

Frail

Like most neurologists, I do EMG/NCV's. This is a test that involves needles and electrical shocks.

It's nobody's idea of a fun test, but we do get a lot of information from it, and for many disorders it's the best test there is for sorting things out.

As a result, it's not uncommon for me to get a fax from another physician's office asking me to do one on a patient. They send over the insurance info and all, and Mary calls the patient to schedule it.

About a week ago I received a fax from Dr. Livingston. It was an order sheet that said "Please do EMG/NCV on Mrs. Geri, possible hand pain." Mary called her number, reached her daughter, and set up the appointment.

Mrs. Geri came in a few days later. She was in a wheelchair, pushed by her daughter. Advanced Alzheimer's disease and incapable of doing anything other than mumbling gibberish. Frail, maybe 90 pounds. Occasionally she'd randomly wave one or the other hand back and forth.

I asked her daughter why Dr. Livingston wanted the test, and her daughter told me it was because of the intermittent hand waving. She hadn't complained of pain (or pretty much anything else).

And... I couldn't do it.

Sorry, Dr. Livingston. The $250 I'd get for putting this poor old lady through an unpleasant test that she couldn't understand seemed more like an exercise in greed and torture than a diagnostic medical procedure.

Not that I really blame Dr. Livingston. I'm sure he was just trying to find out why she'd occasionally wave her hands, but to me it was immaterial. Even if I found something, after putting this sad lady through unneeded discomfort, what would really be done with that knowledge?

I explained this to the daughter and sent them on their way. The billing sheet and her insurance info went into the shredder. I took a loss on the hour and sent Dr. Livingston a polite letter explaining why I hadn't done the test.

I'm sure he can find another doctor to do it. Maybe someone hungrier than I, or less willing to ask questions.

But I just couldn't do it.

Monday, September 10, 2018

Mary's desk

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

Ms. Caller: "Hi, I'd like to make an appointment with Dr. Grumpy."

Mary: "Okay, and what will you be coming in for?"

Ms. Caller: "I have Spritzgong-Fleagle Syndrome, and need to have an MRI done annually to check for new damage."

Mary: "Okay, let's see... This week is pretty busy, but I can get you in next Thursday, at 10:15."

Ms. Caller: "That won't work. I was hoping to get in this week so I can get the MRI done soon."

Mary: "Are you having new problems?"

Ms. Caller: "No, my regular neurologist will be back from vacation next week, anyway."

Mary: "Wait... you already have a neurologist?"

Ms. Caller: "Yes, I see Dr. Stevens, at Huge University Hospital. She specializes in Spritzgong-Fleagle Syndrome, but she's on vacation until next week."

Mary: "Then... why are you calling to see Dr. Grumpy?"

Ms. Caller: "I thought he could order an MRI, then I'd have it when I see Dr. Stevens next week."

Mary: "I'm sorry, but he doesn't cover for Dr. Stevens. You'd have to call her office to get the test done, or wait until she comes back."

Ms. Caller: "Thanks for wasting my time."

Click.

Thursday, September 6, 2018

Parenthood

Dr. Grumpy: "How's she doing with the new medication?"

Mrs. Daughter: "Calmer, but she still treats me like a child."

Mrs. Dementia: "Are we at the doctor's yet?"

Mrs. Daughter: "Mom, this is the doctor."

Mrs. Dementia: "How do you do? This is my daughter."

Mrs. Daughter: "He's met us before, mom."

Dr. Grumpy: "How are you feeling, Barbara?"

Mrs. Dementia: "Don't talk back to me, young man!"

Mrs. Daughter: "Mom, he's the..."

Mrs. Dementia: "You don't talk back to me, either! Go to your room, right now!"

Dr. Grumpy: "Barbara, it's okay."

Mrs. Dementia: "And you're grounded, young man!"

Monday, September 3, 2018

September

Reminding all the guys out there that it's Prostate Cancer Awareness month. So be sure to get checked. And here's some special guests to say more.


Thursday, August 30, 2018

Wednesday afternoon

I'm in line at the bank, and hear this conversation in front of me:



Teller: "Ma'am, I'm sorry, but we can't give you a cash withdrawal without any identification."

Ms. Deceit: "How about I just get the money today? I can come back tomorrow with ID."

Teller: "No, we need a form of identification before giving you the money."

Ms. Deceit: "Like I said, I left my purse at work, or I wouldn't be here in the first place."

Teller: "Well, you can certainly get it and return later."

Ms. Deceit: "Don't be silly. For that kind of trouble I might as well go to different bank. How about if I give you my cell phone number? You can call it right now, and I'll put my phone on the counter. When it rings that will prove it's me."

Teller: "We can't accept that. What we need is a photo ID and..."

Ms. Deceit: "A photo ID is easy. Don't you have a computer back there? I'll show you my Facebook page, so then you can see my picture and know I'm telling the truth."

Teller: "Ma'am, Facebook isn't an acceptable form of identification, and we'd also need to see..."

Ms. Deceit: "This is why I prefer online banking. Places with people in them, like this, just aren't customer-friendly."

(she leaves)

Monday, August 27, 2018

Phone calls

I'm with a patient. Mary interrupts me to say there's another doctor on hold, who needs to talk to me.


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

Dr. Call: "Hi, we have a mutual patient, Mrs. Memory."

Dr. Grumpy: "Hang on, let me pull up her chart... Okay. It looks like I haven't seen her since 2014."

Dr. Call: "Okay, you need to pull her driver's license. I don't think she's safe to drive."

Dr. Grumpy: "I really can't do that after 4 years without seeing her. Why don't you have her family call Mary to bring her in? I can see her tomorrow morning at..."

Dr. Call: "That's ridiculous. She needs to have her license cancelled today. Immediately."

Dr. Grumpy: "Why don't you call the state DMV? You can do it, too."

Dr. Call: "I'm very busy! I don't have time to do things like that! This is your problem!"

Dr. Grumpy: "I..."

Dr. Call: "Okay, since you don't seem to be able to, I'll take care of it. What is the DMV phone number?"

Dr. Grumpy: "I don't know it off the top of my head, but you can..."

Dr. Call: "I'll just have my staff do it. You're not very helpful."

She hung up.

Thursday, August 23, 2018

"Stand back!"

Seen in a bladder-flow report:


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!"


 
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