Tuesday, October 15, 2019

Casa De Mentia

Jack is a nice guy, unfortunately now progressing through Alzheimer's disease. Although his cognition is shot, his baseline friendly personality has stayed with him. He's always accompanied by his doting daughter, Susan, and yesterday there was a guy with them I hadn't previously met.

Dr. Grumpy: "Hi Jack, hey Susan. Have a seat. Hi, sir. I don't think we've met. Are you Jack's son?"

Guy: "No, I'm, uh, actually a tax auditor."

Dr. Grumpy: "A tax auditor?"

Susan: "Yes, I asked him to come with us today. He's auditing our taxes."

Guy: "They asked me to come today. I don't normally go to doctor appointments with people. Actually, this is a first."

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

Susan: "Apparently there's an issue with our taxes. Can you explain?"

Jack: "Hi, Dr. Gravy."

Susan: "It's Dr. Grumpy, Dad."

Guy: "I was sent to audit their taxes because of errors that were, incredulous, to say the least, and my department was concerned about fraud, but when I got there I found that..."

Susan: "Me and Larry have been letting Dad do our taxes."

Dr. Grumpy: "WHAT? You mean, recently?"

Susan: "Yes, ever since we got married 35 years ago. He's always done them."

Dr. Grumpy: "Jack, have you been doing their taxes?"

Jack: "Are we going to be done here before the Cubs game starts?"

Susan: "Daddy, it's football season."

Dr. Grumpy: "Wait... Susan, you let your Dad, who we've done all kinds of paperwork and POA and legal forms on for his Alzheimer's disease, DO YOUR TAXES?!!!'

Susan: "I asked him if he'd still be able to do them, and he said yes."

Jack: "I'm a CPA. Last week I was named to the top 10 CPA's in Bayonne."

Susan: "Daddy, you've been retired for 15 years."

Jack: "Is the Cubs' game on tonight?"

Guy: "Excuse me, doctor, but just to make sure, is this man mentally capable of doing income taxes?"

Dr. Grumpy: "NO. Absolutely not. Do you need me to put in writing?"

Guy: "Please."

Susan: "Dr. Grumpy, I have a question?"

Dr. Grumpy: "Yes?"

Susan: "Do you know a good accountant?"

Wednesday, October 9, 2019

License plate of the year

Thank you, Glenn!

Monday, October 7, 2019

Random pictures

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

From the "you need a hobby" files:

One reader vacationing in San Diego sent in this picture of her hotel's emergency exit sign:

And now, to stress the importance of online security:

From the "Safety is job #1" files:

And, finally, "chewy" is apparently now a flavor:

"It. Tastes. Like. What?"

Thursday, October 3, 2019

Mary's desk

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

Ms. Call: "Hi, I'm trying to reach Dr. Freenbeen."

Mary: "He doesn't work here, this is Dr. Grumpy's office. Let me look up Dr. Freenbeen's number for you."

Ms. Call: "I already have it. I can't reach him. That's why I called you."

Mary: "Oh... We're not affiliated with that office at all."

Ms. Call: "Yes, but I still need to reach them. I can't get through. The internet says you're both neurology offices, so I figured you'd have a way to."

Mary: "No, we don't"

Ms. Cell: "There isn't some secret network that connects you people? I saw that on the internet, too."

Mary: "There is no such thing. I have the same phone numbers you do."

Ms. Cell: "You people are so unhelpful."


Monday, September 30, 2019

Beware of the Dragon

Seen in a chart:

Thank you, J!

Monday, September 23, 2019


College kid: "Uh, hello?"

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

College kid: "Oh, hi Dad... Um, with what?"

Dr. Grumpy: "I got copied on an email from the university this morning that last night you'd violated some dorm rule by having an extension cord going all the way down the hall?"

College kid: "Oh, that... Yeah, I promised them it won't happen again. It was just an extension cord, though. I think they're making a big deal over it. Everyone has an extension cord."

Dr. Grumpy: "They told me it went from your room, down a hall, down 2 flights of stairs, down another hall, down the main front staircase, through the lobby, and then outside and about halfway across the parking lot."

College kid: "Yeah, I, uh, it was actually pretty impressive. I had to borrow extension cords from a lot of people to do that."

Dr. Grumpy: "They said people were tripping over it."

College kid: "Well, I mean, that explains why it's against the rules, I guess. It's a good idea, actually, if you think about it."

Dr. Grumpy: "That's a big "if." Why weren't you thinking about it? And what the hell were you doing that you had to have an extension cord going that far, anyway?"

College kid: "You know, uh, Dave, that guy down the hall from me? The one with the weird BO? Anyway, we were arguing about how far the dorm's WiFi range goes, so decided to take my laptop into the parking lot to find out."

Dr. Grumpy: "It's a laptop. Why did you need an extension cord?"

College kid: "Well, that girl, Kelly, in my graphic design group, needed a battery for her laptop, and the one she ordered online isn't in yet, so I loaned her mine. So to get my laptop to work to test the WiFi I had to have it plugged in, and to get it far enough out there needed a REALLY long extension cord. So I had to borrow a lot of them from other people in the building."

Dr. Grumpy: "Why didn't you just connect your phone to the dorm's WiFi and walk outside to test it that way instead?"

Long pause.

College kid: "That's a, uh, really good question. Look, Dad, I have to go, because I've got a bunch of extension cords I have to return to people."

Thursday, September 19, 2019

Avast ye, mateys!

It's International Talk Like a Pirate Day!

To celebrate, here's the pirate-themed heavy metal band (you probably didn't know this musical genre existed, did you?) Alestorm, singing about stealing rum and beer.

And the guy elevates rolling the letter "R" to an art form.

Monday, September 16, 2019

Seen in a chart

"Make up your mind, will you?"

Thursday, September 12, 2019

Chief complaint

My colleague, Dr. L., says she's studying for her neurology boards, and was taking a practice test last weekend.

This question was on it, and she says she's never had a patient report answer E to her.

I'd have to agree. At least not without a Ouija board.

Thank you, Dr. L!

Monday, September 9, 2019

Thanks, Sherlock

A drug rep marketing an epilepsy medication brought lunch in for Pissy and I, so we were having the usual 30 minutes of catered sandwiches and pamphlets full of glossy pictures, graphs, and small print.

As we talked, she mentioned that, as part of her new-hire training, she was sent to volunteer at Camp Shaking Pines this past summer. This is a summer camp held for children with epilepsy who, for medical reasons, can't go to other camps. The purpose of her 3 days there was to "raise my awareness" of epilepsy.

Then she said "Doctor, do you know that some of those kids, the ones with seizures, will actually have seizures, right there, at seizure camp?"

I heard a thud behind me as Pissy's hand hit his face.

Monday, September 2, 2019

Breaking news!

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


British police have apologized after what they previously described as a "huge drugs bust" turned out to be vegan cake mix.

Staff of Purezza, a vegan restaurant, were transporting a large amount of vegan cake mix in a suitcase when it was confiscated at Gatwick airport by transportation police.

After identifying the powder as cake mix, the bags were returned to the restaurant. The staff has offered the police free cake, though at press time the police haven't accepted.


An 80 year-old woman had her vehicle stolen. While she was asleep in it.

Police say the lady had dozed off after parking her car, and when she woke found herself lying in the driveway. She had no recollection of being taken out of the car.

The car has since been recovered.


No one was injured when a bear landed on a police car.

In an unusual chain of events, a Humboldt county sheriff's deputy was driving on Route 96 when a bear fell off a steep embankment and landed on his patrol car. The hood and windshield were smashed.

The surprised officer lost control of his bearmobile, which slammed into the embankment, rolled onto its side, and burst into flames.

This resulted in a small forest fire, that burned about half an acre.

The officer was unharmed.

The bear fled the scene, and was not available for comment.

Thursday, August 29, 2019


Today's post is dedicated to the marketing genius at Boehringer-Ingelheim pharmaceuticals who came up with this name for their veterinary portal:

Good luck on your job search.

Thank you, Webhill!

Monday, August 26, 2019

Free samples

Mr. Dixie: "Hey, doc, do you need to check levels on my seizure medication today?"

Dr. Grumpy: "No, I don't."

Mr. Dixie: "You sure? Like, need a urine sample?"

Dr. Grumpy: "No, and it would be blood, anyway."

Mr. Dixie: "Oh... Well, I thought you might, so I left a cup full of piss out in your lobby bathroom, just in case. It has my name on it."

Dr. Grumpy: "Um, we don't have sample cups out in the lobby bathroom?"

Mr. Dixie: "I know. I took it off your water cooler."

Thursday, August 22, 2019

Big Donor

Dr. Grumpy: "How you doing today?"

Mr. Big Donor: "I'm tired. You wouldn't believe what happened to my daughter's husband last night."

Dr. Grumpy: "He okay?"

Mr. Big Donor: "My son-in-law, Todd, was hanging up some pictures last night and accidentally hammered his thumb. It was really killing him. Maybe he broke it. He ended up having to go to ER."

Dr. Grumpy: "Ouch. That must have hurt."

Mr. Big Donor. "So he finally went there around midnight, and they left him sitting in the lobby. He said they kept bringing all these people from ambulances in ahead of him, and this one lady who had something stupid, like chest pain, got taken right back."

Dr. Grumpy: "  "

Mr. Big Donor: "So he finally called me when he remembered I'm on the hospital foundation's board. I was so angry. I called Dr. Brown... you know him? He's CEO over there? I have his home number and woke him up and told him about this bullshit they were doing to Todd. He took care of it, and they got Todd back in the next 5 minutes. But it's such crap that I even had to do that. I mean, I'm not a doctor, but even I know how a health care system should work. But the dimwits in ER have no clue."

Monday, August 19, 2019

Seen in a chart

I have no idea what this means, or why it's listed as a therapy.

Thursday, August 15, 2019


About 10-15 years ago, there was an internist who took night call doing hospital admissions. He worked from 5pm - 7am, and I was usually there from 5am to 6pm, so we encountered each other a fair amount toward beginning and end of day.

He was an eccentric dude (though a good doc), the type who tends to be best working night shift. He always had a large briefcase with him. Everywhere. It never left his side. No one but him knew what was in it, was never seen open. He took it in patient rooms, the bathroom, the doctors lounge... everywhere.

Late one afternoon I got called to see a guy admitted for a minor stroke. He was a retired baseball Hall-of-Famer. So I went in, and was talking to he and his wife, doing my usual neurology stuff.

I’d just finished answering their questions when Weird Doc and his huge briefcase wandered in to do the admission. He came in, set the briefcase down. I handed him the chart, since I was done with it and headed for my next consult. He glanced at it, then said “OH MY GOD! YOU’RE MIKE HOMERUNSLAMMER! CAN I PLEASE HAVE YOUR AUTOGRAPH?”

He opened the briefcase. I may have been the only person on Earth (besides him) to have seen its contents. It was crammed full - and I mean REALLY full - of baseball cards. I'd never seen so many. All neatly arranged by teams and years.

He rummaged through it and pulled out the guy’s card from some year. And a pen. And a clipboard. and handed them to the patient. Somewhat stunned (I was kind of in shock myself) he signed it, handed it back, and the briefcase was closed.

Then he pulled his stethoscope out of his pocket and started business. "Thank you! So, what brings you to the hospital today?"

Monday, August 12, 2019

"I'll take that as a yes."

Dr. Grumpy: "Did you have a headache when these other symptoms occurred?"

Ms. Patient: "Well, I believe I may have, if that was my awareness of how I felt was to have had a headache at the time than it could have been that I was possibly aware of having a headache."

Thursday, August 8, 2019

Fun with EMR

I went to look up a patient's blood pressure trend at the hospital, but only found this:

People's lives depend on this, too. Don't that just make ya feel good?

Monday, August 5, 2019


I get in the hospital elevator with a 30-ish woman who's talking to someone on her cell phone. I hear:

"No, seriously, Sue, all the doctors here are idiots. Nurses, too. I mean, they tell me stuff about Mom's condition and tests and stuff, and I google it, and it always says the opposite of what they're saying. This place is a deathtrap. I'm trying to get her transferred somewhere else, where people know what they're doing."

Thursday, August 1, 2019

Love and marriage

While on call last weekend, I was trying to track down a few victims patients when I noticed my call partner's (Dr. Nerve) wife was in one of the rooms on the floor. So I went in to say hi.

Dr. Grumpy: "Hi... Wow, that's a big cast. What happened?"

Mrs. Nerve: "He talked me into going on one of his overnight hikes-to-hell yesterday, in Southstate Canyon. About halfway through I tripped on a rock and broke my ankle."

Dr. Grumpy: "Holy crap. Are you okay?"

Mrs. Nerve: "Yeah, they operated on it last night."

Dr. Grumpy: "That's a pretty remote area. Did he have to carry you out?"

Mrs. Nerve: "No, they sent a helicopter and airlifted me here. We were WAY off the regular road."

Dr. Grumpy: "Where is he?"

Mrs. Nerve: "No idea. After I broke the leg he called for the helicopter and left. He said he was going to finish the overnight hike, and would meet me back here today."

Monday, July 29, 2019

Random pictures

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

First, from the "what the hell does that mean?" files:

In the build-up to July 4, one reader noticed that this lonely fire-extinguisher isn't particularly reassuring if the whole pile goes up:

Then we have this sign, from the "look, I said it already" department:

Apparently the Utah Shakespeare festival is presenting one of the Bard's more popular works:

I'm guessing this newsflash was written by someone who really loved "Death Race 2000"

Reader A writes that her mother's recent attempt at baking bread came out vaguely obscene:

Another got this offer on his phone, and says that he personally wouldn't drink any product whose name sounds somewhat like "diarrhea."

Dr. K says that when he and his family were at a resort last month they put this up before Father's day:

And, lastly, it's kind of scary they have to remind people not to do this:

Thursday, July 25, 2019


Not-so-great moments with using Epocrates:

Monday, July 22, 2019


I'm sitting in my office with an elderly lady with Alzheimer's disease and her devoted son.

Dr. Grumpy: "So how's she been doing?"

Mr. Son: "Better, at least a little. I mean, her memory is still pretty bad, but she's calmer, and the nurses tell me she's more cooperative and isn't yelling since you started the new medication."

Dr. Grumpy: "Has she..."

Mr. Son's phone rings and he looks at it.

Mr. Son: "I better answer this, it's Casa DeMentia, her memory-care place. I'll put it on speaker phone in case you want to ask them anything... Hello? This is Mr. Son."

Susan: "Mr. Son, this is Susan. I'm the charge nurse at Casa DeMentia. I'm calling to let you know that your mother isn't in her room, and we've searched the building and grounds thoroughly and can't find her. We're afraid she somehow wandered off..."

Mr. Son and I both look at the patient, who's calmly sitting in my office leafing through an upside-down magazine.

Susan: "... so our security people are going to review video to see what happened, but I wanted to make you aware. I'm going to call the Grumpyville police for a Silver Alert, too, and..."

Mr. Son: "Um, my Mom is right here with me. We're at Dr. Grumpy's office. I signed her out at the front desk when I picked her up."


Susan: "Cindy, before you told me Mrs. Memory was missing, didn't you check the sign-out book first... WHY THE HELL NOT? You (expletive)."


Susan: "I'm so sorry to bother you Mr. Son. Will she be back for lunch?"

Thursday, June 27, 2019

Heading out

It's summer vacation time, gang.

I'll be heading out for a few weeks with my wild bunch.

Back sometime in the second half of July.

Until then, have a great summer. Or, if you're reading this from the southern hemisphere, have a great winter.

And so it begins.

Monday, June 24, 2019

Seen in a chart

Thank you, K!

Thursday, June 20, 2019

Patient quote of the day

"I was watching health news on TV this morning. Did you know you can die if your heart isn't working right?"

Monday, June 17, 2019


Three elderly ladies are sitting on a bench outside the nursing home when an older gentleman walked by.

One of the ladies yelled out, “Hey, I bet we can guess how old you are!”

The old fellow said, “There is no way you can guess my age! I look great for my age.”

One of the women said, “Yes we can!”

“No, you can’t!”

“Can! Just drop your pants and undershorts and we'll tell your exact age.”

The gentleman was embarrassed, but wanted to prove they couldn't do it. So... he dropped his drawers and let it all hang out.

The ladies asked him to turn around a few times while they looked from different angles, then had him jump up and down twice.

They then whispered back and forth for a minute, and finally one said. “You're 87-years-old.”

The fellow was stunned. Standing with his pants down around his ankles, he asked, “You’re right. WOW! How in the world could you tell?”

There was a pause, then one woman answered “Last week we were all at your birthday party.”

Thank you, Webhill!

Thursday, June 13, 2019

Seen in a chart

Monday, June 10, 2019

Annie's desk

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

Mrs. Faa: "Hi, this is Mrs. Faa. I was hoping you'd be able to help me."

Annie: "Sure... let me just pull your chart up... Okay, what's up?"

Mrs. Faa: "How do I get blood out of my carpeting?"

Annie: "Uh, well, hydrogen peroxide, or..."

Mrs. Faa: "No, I mean, do you know a good carpet cleaning company in my area? I broke a glass in the kitchen, and then stepped on a big shard while trying to clean it. So there's blood everywhere from when I walked to my bathroom to get a band-aid. It's a mess."

Annie: "Well, I don't know who's in your part of town, but let me look some up."

Mrs. Faa: "I bled A LOT. I mean, literally, all the blood has been drained out of my body. I have no blood left in me at all. It's all on the carpet."

Annie: "Do you need to go to ER?"

Mrs. Faa: "Why? Will someone there help me clean it up?"

Thursday, June 6, 2019

June 6, 1944

"There have only been a handful of days since the beginning of time on which the direction the world was taking has been changed in one 24-hour period by an act of man. June 6, 1944, was one of them.

"No one can tell the whole story of D-Day. Each of the 60,000 men who waded ashore that day knew a little part of the story too well. To them the landing looked like a catastrophe. Each knew a friend shot through the throat, shot through the knee. Each knew the first names of five hanging dead on the barbed wire offshore, three who lay unattended on the beach as the blood drained from the holes in their bodies. They knew whole tank crews who drowned when their tanks were unloaded in 20 feet of water.

"There were heroes here no one will ever know because they're dead. The heroism of others is known only to themselves.

"What the Americans and the British and the Canadians were trying to do was get back a whole continent that had been taken from its rightful owners. It was one of the most monumentally unselfish things one group of people ever did for another.

"It's hard for anyone who's been in a war to describe the terror of it to anyone who hasn't. How would anyone know that John Lacey died in that clump of weeds by the wagon path as he looked to his left towards Simpson and caught a bullet behind the ear? And if there had been a picture of it - and there weren't any - it would've shown that Lacey was the only one who carried apples for the guys in his raincoat pocket.

"If you think the world is rotten, go to the cemetery at Saint-Laurent-sur-Mer on the hill overlooking the beach. See what one group of men did for another, D-Day, June 6, 1944."

- Andrew Rooney (1919-2011)

Monday, June 3, 2019


Betty Tau: "Hello?"

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

Betty Tau: "Dr. Grumpy isn't here."

Dr. Grumpy: "Hi, Betty, this is Dr. Grumpy. Did your daughter call me?"

Betty Tau: "Dr. Grumpy isn't here. You have a wrong number."

Dr. Grumpy: "Betty, is your daughter there?"

Betty Tau: "No, but I think she was trying to reach Dr. Grumpy. Do you know him?"

Dr. Grumpy: "This is Dr. Grumpy, returning a call for your daughter. Why don't you put her on the phone?"

Betty Tau: "I told you, Dr. Grumpy isn't here. You'll need to ask my daughter what his phone number is. She handles those things. If you want Dr. Grumpy you should call his office and leave us alone."


Tuesday, May 28, 2019

"Grandma, what did you bring me?"

This fellow was being handed out at the recent immunology meetings.

Thank you, M!

Thursday, May 23, 2019

Criswell predicts

Dr. Grumpy: "Okay, so I'll have Annie set up the MRI for you, and then..."

Ms. Dixon: "What do you think it will show?"

Dr. Grumpy: "It's hard to say. I don't think there's anything of alarm, but with your symptoms I'd like to make sure I'm not missing anything."

Ms. Dixon: "So you really aren't sure?"

Dr. Grumpy: "No, that's why I want to get the test."

Ms. Dixon: "This is kind of disappointing. I thought you'd be able to tell me what it would show, that way I wouldn't need to have it in the first place."

Sunday, May 19, 2019

One of these things is not like the others

Monday, May 13, 2019

Short visit

Seen in a chart:

Thursday, May 9, 2019


Mary: "Hello, this is Mary from Dr. Grumpy's office. I wanted to confirm Mr. Lumbar's appointment tomorrow with Dr. Grumpy."

Mrs. Lumbar: "Oh, he won't be coming in. The back pain doesn't bother him anymore."

Mary: "Oh, okay, well I'm glad to hear that."

Mrs. Lumbar: "He's dead."

Tuesday, May 7, 2019

History reruns

May 7, 1915

Today in history, in a factoid well known to school children, the R.M.S. Lusitania was sunk by a German submarine with a loss of 1198 lives.

And... that little snippet is pretty much all most people know about the disaster.

The details are forgotten compared to her erstwhile competitor, Titanic. Nobody made a blockbuster movie about her. Plenty of books have been written, but they often focus on the debated aspects. Was the ship a legitimate target? Did the British admiralty intentionally put her in harm's way? Was she carrying priceless paintings? These questions will never be settled, and I won't debate them here.

Americans are taught that the sinking is what brought the U.S. into WWI. Horseshit. It certainly contributed, but was only a small part. In fact, President Wilson fought like hell to stay out afterwards, and the U.S. didn't enter the war for another 2 years. The resumption of unrestricted submarine warfare in 1917 was a bigger factor. And, although mostly forgotten now, the Zimmerman Telegram was likely the event that finally pushed America into hostilities. Except for those of you who (like me) are fascinated by history, you've probably never heard of it.

A voyage then was a far cry from cruising now. Today's ships are designed for entertainment, with shows, games, shopping malls, climbing walls, mini-golf courses, and countless activities. They're rarely at sea for more than 2-3 days (at most) and frequent port stops are part of the attraction.

That wasn't the case in 1915.

To get some idea of intercontinental travel in the pre-flight age, think of this: You were in a large hotel for 10-20 days. You couldn't leave. You didn't stop in port until the end. The restaurants, though opulent, were the same. Your fellow travelers, and the crew, never changed. The only entertainment provided by the ship were small orchestras for 1st and 2nd class, an exercise room, and a meager library. 3rd class slept in large dormitory-like rooms that doubled as their dining areas, and their only entertainment was whatever instruments and reading they'd brought. The North Atlantic crossing, arguably the busiest and most economically important of the era, was rainy, cold, and windy. The ships didn't have the stabilizing systems we take for granted today, and rolled with the choppy seas.

The Lusitania's stories are mostly forgotten (like the Empress of Ireland) probably because of the time scale involved. From start to finish the sinking took 18 minutes. In that sort of time, on a rapidly foundering ship, the overall reaction is rushed panic. The Titanic, in contrast, floated for 2 hours and 38 minutes after striking the iceberg. Enough time to avoid panic and for the norms of Edwardian society to dictate the events. Women and children first. Rich before poor. Americans & Britons before immigrants. Stories of the band playing to the end, of Isidor & Ida Straus choosing to die together rather than get in a lifeboat ahead of younger people, or the chief engineer who went back to carry out a crewman with a broken leg - with neither ever seen again. Thousands of stories in 158 minutes that immortalized the disaster.

In just 18 minutes, those on the Lusitania didn't have time to do much but try to get in a lifeboat. Most failed. Although (unlike the Titanic) she had enough lifeboats for all, the slope of the sinking hull, and the rivets holding it together, made it difficult to launch them. Many dumped people out before hitting the water.

But stories are there, you just have to look for them.

The Lusitania herself was a technological marvel. The first liner fitted with the revolutionary new steam turbines that today run everything from nuclear submarines to power plants. The first ship to have a central climate-control system (the ancestor of air-conditioning) to keep the interior at a steady 68°F, regardless of outside weather. The system also exchanged the air inside the ship 7 times every hour, eliminating the need to open portholes on a cold day. And, for a time, she was the fastest liner to ever cross the Atlantic.

On the antagonist in the tragedy, the submarine U-20, was a story. The ship had been identified as a large passenger liner, and Kapitanle├╝tnant Walther Schwieger still had every intention of sinking her. He gave the order to fire, and it was the job of Quartermaster Voegele to relay it to the torpedo room.

But Voegele wouldn't. He told Schwieger he refused to carry out an order that would kill innocent civilians. Schwieger immediately relieved him of his post and had another officer do it. After returning to land, Voegele was court-martialed and spent the rest of the war in prison.

Very few stories are as popular, or been "re-booted" as much, as Peter Pan. From the Walt Disney cartoon, to Dustin Hoffman's "Hook," to 2003's "Neverland," the tale has been imagined and re-imagined, both in movies and theater, many times. And Tinkerbell now has her own spin-offs.

But the odds are you'd never have heard of Peter Pan or Tinkerbell if it weren't for a man named Charles Frohman. One of the leading theater producers of the era, he was instrumental in bringing the story to stage. First in London, then in America, he put J.M. Barrie's once obscure story in front of live audiences night after night. Frohman even had the title changed, from the original "Peter Pan - the Boy Who Hated Mothers" to the one you know: "The Boy Who Never Grew Up." It's as immortal as a tale can be.

Frohman died on the Lusitania, at age 58. Unable to jump into a lifeboat due to severe arthritis, and not knowing how to swim, he knew his life was coming to a close. He spent his last minutes with the wealthy Alfred Vanderbilt (age 37, also couldn't swim, and refused to get in a lifeboat ahead of women), tying life jackets to the nursery's baby baskets to make sure the infants would float. As the end approached Frohman turned to actress Rita Jolivet (who survived), and quoted from Peter Pan “Why fear death? It is the most beautiful adventure that life gives us." Then he disappeared under a surge of water.

As Margaret Mackworth and her friend Dorothy Connor watched the frantic rush for the lifeboats, Margaret commented that "I've always thought a shipwreck was a well-organized affair." Dorothy replied "so have I, but I've learned a devil of a lot in the last 5 minutes." An hour earlier, at lunch, Mackworth had told others at her table "It's been such a dull, dreary, stupid, trip. I can't help hoping that we get some sort of thrill going up the channel."

In Chicago, Illinois is Ambrose Plamondon Elementary School. Mr. Plamondon was a major American steel industrialist of the 19th century. When he died his son Charles took over the vast company... And, along with his wife, died on the Lusitania.

Another survivor who ran down to get her lifebelt remembered passing an open door, where inside a middle-aged woman cheerfully arranged and re-arranged her suitcase unconcernedly, as though they were about arrive in port.

In New York, Cunard's local director watched a crowd gather outside his office as news drifted in. He remembered watching a similar crowd outside the rival White Star Line office across the street 3 years earlier, hoping it would never happen to him.

The worst of human nature was on display that night through America, Ireland, and Britain. Mobs attacked and burned business and homes owned by families of German descent, or even those with vaguely German-sounding names.

To the people of Queenstown (now Cobh), Ireland, fell the rescue. As the first S.O.S. crackled from the Lusitania, local fisherman (who'd just come in to unload from the morning) frantically untied their boats and headed back out to sea to save as many as possible. It was a motley collection of mostly sailing boats, a few faster ones with engines, and even some that were being paddled. Boys standing on the cliffs of Kinsale to watch her pass saw the explosion, and helped spread the alarm to local life-saving patrols. The exhausted fishermen worked into the evening to save as many as they could.

As the 767 survivors came into town on overloaded boats, the townspeople rushed blankets and food to the docks. They found places to shelter the fortunate ones - in homes, hotels, warehouses... anywhere there was space - until Cunard was able to make arrangements.

To the locals also fell the unenviable job of handling bodies that were picked up by boats or washed ashore for the next several weeks. Those that could be identified were sent home, but many were beyond that. So three large mass graves, with coffins stacked 2-3 high (some with 2 children put in them) were dug at the Old Church Cemetery. More were buried in Kinsale, at the Church of St. Multose.

Some of the victim's names were known only to their families, sadly being listed on the roster just as "Mr. Stanton's manservant" or "Lady Adam's maid."

In 1912, as the Titanic was about to leave port, the suction from her powerful propellers pulled another liner, the S.S. New York, away from the dock. The 2 ships missed colliding by roughly 3 feet before tugboats could push them apart. Now, 3 years later, the New York was linked to another tragedy. The American government chartered her to bring citizens, living and dead, back to the states. She carried the bodies of Charles Frohman, the Plamondons, and many others.

Survivor Herbert Ehrhardt took off his shoes and gave them to a shivering man in his lifeboat while awaiting rescue. They didn't quite fit, but the man said they'd do. The next day Ehrhardt (and many others) went to a Queenstown shoe store to replace them. As he waited to be helped, he noticed his original pair lying discarded on the floor. He laced them back on and left.

U-20, the submarine that sank Lusitania, ran aground off Denmark in November, 1916, and was subsequently demolished. What's left is roughly 1200 feet from shore, under sediment. The conning tower was removed and is at a local museum.

Captain William Turner of the Lusitania survived the sinking when a wave washed him off the bridge. He was pulled from the water, unconscious, by the crew of a fishing boat. Although exonerated by the inquiry, public opinion held him to be at fault for not taking preventative measures. His wife and sons left him, and he never saw them again. He was assigned to command the ship Ivernia in 1917, which was sunk in the Mediterranean by a submarine. He survived again, but never returned to sea and died in 1933.

Kapitanle├╝tnant Walther Schwieger was killed in September, 1917, when his next submarine struck a British mine.

The last survivor of the Lusitania, Audrey Lawson-Johnston, died at age 95 in 2011.

The once-beautiful Lusitania lies, collapsed on her starboard side, in 300 feet of water off Ireland. While the bow section of the Titanic still evokes a sense of grace and majesty, the Lusitania is little more than a large scrapyard. Her much shallower depth makes her susceptible to the effects of tide, weather, and temperatures. The attack by U-20 was also just the beginning. Countless times in WW1 and WW2 there was concern U-boats were using the wreck to hide, and so it was aggressively depth-charged by destroyers to scare them off.

The hundreds in the mass graves, whose identities will never be known and whose families never saw them again, are marked at the Old Church Cemetery by a single large stone.

Monday, May 6, 2019

Quote of the day

"I was in the ER last weekend for a seizure. They said my Dilantin level was 8. Or maybe it was 18, or 28. I don't know, it was a number with an '8' in it. Does that help?"

Thursday, May 2, 2019


Garlic, like a lot of old dogs, is covered with random lumps, bumps, and warts.

This past weekend Craig was having a party (actually, Craig seems to have a party every weekend, but that's another post).

As usual, Garlic and Onion were making the rounds, hoping to snag a pretzel or fallen cocktail weenie. At one point one of Craig's entourage groupies harem friends began petting Garlic, so he hopped up on the couch next to her to keep the attention coming.

A few minutes later she noticed me wandering out of my office to get a Diet Coke and came over to ask...

"Hi, uh, Mr. Craig's dad. How come your dog has nipples growing out of his back?"

Monday, April 29, 2019

Check out

I was on call for the weekend, so Sunday night had the usual check-out call with Dr. Cortex:

Dr. Cortex: "Hello?"

Dr. Grumpy: "Hi, it's Grumpy."

Dr. Cortex: "Okay, let me get my list and a pen..."

Dr. Grumpy: "How was your weekend? You guys do anything?"

Dr. Cortex: "We took the grandkids to the annual air-show, but, one of the planes crashed while landing. They said the pilot was killed and the passenger badly injured. Fortunately, we were at the snack bar when it happened, so Billy and Dolly didn't see it. But it must have been horrible. We left right away."

Dr. Grumpy: "I don't blame you."

Dr. Cortex: "All right, I'm ready for the list. What have you got for me?"

Dr. Grumpy: "Okay. In the ICU, room 37, is a guy with a serious head injury. He was a passenger in a plane at the air show......."

Thursday, April 25, 2019


Dr. Grumpy: "Did you have those labs done?"

Mr. Siphonaptera: "Hell no. I walked out of the lab. They treated me like crap."

Dr. Grumpy: "What happened?"

Mr. Siphonaptera: "The girl at the front desk told me she was going to have me see a phlebotomist, which is bullshit. I don't have fleas. So I left."

Monday, April 22, 2019

11:38 p.m.

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

Ms. Papaveraceae: "Hi, I'm a patient of Dr. Brain's, and I ran out of Percocet. My pharmacy number is..."

Dr. Grumpy: "I'm sorry, but I don't call in controlled drugs after hours. You'll have to contact Dr. Brain's office on Monday."

Ms. Papaveraceae: "But I really need it!"

Dr. Grumpy: "I can't call in any narcotics. What I can call in is..."

Ms. Papaveraceae: "But I can't take anything else because of religious reasons. I belong to a small sect that worships poppy flowers, so..."

Dr. Grumpy: "I'm not calling narcotics in."

Ms. Papveraceae: "So you're discriminating against me on the basis of my religion? I will get an attorney and..."

Dr. Grumpy: "Have a good night."


Thursday, April 18, 2019


Last week I received a letter from a research company, looking for "experts in a specific field."

It asked if I could answer "yes" to any of the following questions:

Monday, April 15, 2019

In Memoriam

My kids have now passed one of the milestones of modern adolescence.

The death of your first car.

The boys aren't having much of an issue with this, but Marie is taking it vary hard. The 4Runner was her baby.

You may remember her adventures with the car, when she outraced her older brothers to be the first with a license. The Toyota was 19 years old, with 265,000 miles, but she loved it. For reasons known only to her she named it "Dakota," which she insisted on spelling "decoda."

And, fittingly, it died with her at the wheel.

Rolling down the freeway on her way to an off-campus class, it suddenly began shaking wildly under her and making a racing noise. Alarmed, she took her foot off the gas and started to pull into the emergency lane. Then there was a loud "BANG!"

The engine stopped, never to turn again. As she came to a halt, Marie noticed a lot of fluid and some pieces of metal in the road behind her.

Since nothing fazes Marie, she calmly called AAA to arrange a tow, only bothering to notify her parents of this change in events when AAA asked where they should haul the car.

The next morning the guy at the car place asked if I could swing by on the way to work. Taking me into the garage, he showed me a jagged hole in the engine block the size of a football. As I marveled at it he handed me a chunk of metal that used to be piston, and pointed out where he'd found it embedded in the undercarriage.

I thought it looked like a femur. Keys are for size comparison.

So, after circling the globe 10.5 times, the car is being donated to charity.

We went to the repair shop before it was towed away to strip it of our personal stuff. This included $5.82 in coins scattered in cup holders, seat cushions, and under floor mats.

Marie carefully pried the 4Runner nameplate off the back, and it's now hanging in her bedroom, next to the hunk of piston.

Thursday, April 11, 2019

I'd have to agree

I'd just finished doing an EMG/NCV on a patient.

Dr. Grumpy: "I hope that wasn't too bad."

Mr. Needle: "Nah, it went fine."

Dr. Grumpy: "Good."

Mr. Needle: "Yesterday they stuck a camera up my dick. That was much worse."

Monday, April 8, 2019

Seen in a chart.

If this MRI finding is correct, it's a publishable case.


Thursday, April 4, 2019

My readers write

I'd like to thank the person who sent in this allergy list:

"Really? I have more trouble with their teeth and claws myself."

Monday, April 1, 2019

You don't know jack

NOTE: the following is NOT an April Fool's Day joke.

I'd like to thank the Science Marches On Department for sending me a truly remarkable piece of research.

Scheduling in a medical clinic requires talent, skill, and magic. There's only so much time in a day, and a lot of patients who need to be seen. People often portray the front-desk wizards as brainless, but they're far from it. Mary, after 14 years, knows me and my patients. From a few seconds on the phone she can get a good idea of how much time any particular patient will need, how that meshes in with the rest of my schedule, and (based on history) how long I am with any given return.

She also has to figure in how long it take takes me to grab a Diet Coke and drain a previous one between visits.

Any practice faces this issue, so obviously some research goes into improving work flow.

A study out of Miami, Florida recently looked into this important subject to calculate times needed for appointments at a fertility clinic.

Specifically, how long it took for a guy to, uh, shake hands with the milkman.

Yes, they wanted to know. That.

In the study guys were given a donation cup and unnamed porn mag. A stopwatch was started at the time they entered the room. They then took matters into their own hands, and texted "done" to the stopwatch person after the research project had climaxed.

For privacy, the exam room had a curtain. Boy, that's a relief.

Admittedly, it sure beats the idea of having a burly orderly with a timer in there, watching you box the one-eyed champ, but still.

The study makes no mention if the guys were allowed to wash their hands before picking up their phones to text the desk afterwards.

This graph is, by far, the best part of the article. It shows how long a guy takes to let it fly while pumping gas vs. the number of patients seen that day.

Note the blue bars: some guys actually had their ladies in the room during the process, although, under the fertility protocols, they weren't allowed to have physical contact. So the bottom line is that, if someone is watching you polish the banister, it will take longer to finish the job. In fact, the ONLY guy in the study who was unable to successfully finish marching the penguin was one who had his girlfriend in there.

Who could have seen that coming?

You can read the study itself here. It has pictures of the exam room, and a porn mag with a brown paper cover on it.

Thank you SMOD!

Sunday, March 24, 2019

Spring break

Taking a few days off for kid stuff. See you next week!

Saturday, March 23, 2019

Musical Gobstopper

For those of you who somehow haven't seen the totally awesome SNL "Bodega Bathroom" musical number, here it is. You're welcome.

Thursday, March 21, 2019

11:52 p.m.

I'm sound asleep when my iPhone rings. It's my call partner, Dr. Cortex.

Dr. Grumpy (mumbling, trying to wake up): "This is Dr. Grumpy."

Dr. Cortex: "Hi, it's Cortex."

Dr. Grumpy: "Why are you calling? Aren't you in the hospital for hip surgery?"

Dr. Cortex: "Yeah. Hey, did you round on my patients today?"

Dr. Grumpy: "Yes."

Dr. Cortex: "Did you see the guy in alcohol withdrawal in room 6824?"

Dr. Grumpy: "Yes, why? I think I ordered all the usual tests."

Dr. Cortex: "Because after I left recovery they put me in the room next to him, and he's screaming nonstop and I can't sleep. He's driving me nuts. I'm going to put you on with his nurse now, so you can order something to sedate him."

Monday, March 18, 2019

Seen in a chart

Monday, March 11, 2019


I'm at the dreaded Wednesday morning neurology meeting at the hospital. My colleague, Dr. Mom, is sitting next to me.

About halfway through the meeting her iPhone rang. She answered it, listened for a few seconds, then said:

“LOOK, Mr.-I-had-a-Bar-Mitzvah-so-now-I-am-a-man, I don’t care how well you did at your Bar Mitzvah, the fact that you forget your lunch at home - again - still makes you an irresponsible moron in my book and you can shut up and go hungry for the day to learn a lesson and if you call me about this again you’re not getting dinner either!”

Then she hung up.

We fist-bumped.

Thursday, March 7, 2019


You know, it's REALLY PATHETIC that 40 years after this public service announcement first ran, we need it now more than we did then.

Get your kids vaccinated. Don't believe the bullshit out there.

Monday, March 4, 2019


School competitions always bring a bunch of paperwork, rules, and forms for parents to sign.

This year they included this:

Thank you, A!

Thursday, February 28, 2019


I'm with a patient when Mary interrupts me. Dr. Unka, a deranged cardiologist in my building, is on the phone. So I apologize to my patient and pick up the line.

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

Dr. Unka: "Hi, Ibee. You consulted on a hospital patient of mine this morning, Mr. Sah. He's the one who fell and hit his head at home yesterday, and now has a brain hemorrhage?"

Dr. Grumpy: "Yeah, he's in ICU. What's up?"

Dr. Unka: "Well, I was reading your note, and in your dictation it says he slipped on water that was on the floor. I just spoke to his wife, and she's very certain it was iced tea, because he'd just knocked a glass over and was going to get a towel to clean it up when he fell."

Dr. Grumpy: "Um..."

Dr. Unka: "Anyway, I thought it was important you should know, in case you want to amend your dictation."

Monday, February 25, 2019

Breaking News!

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


Diners waiting for burgers in the drive-thru of an A&W restaurant kept waiting, even after it became obvious the restaurant was burning down.

In a remarkable testament to human optimism, brand devotion, and hunger, patrons were, apparently, convinced their dinners would be ready soon. This is in spite of smoke pouring out of the place, employees fleeing the building, and approaching sirens. In fact, more people just kept pulling in. One can only assume they thought the column of smoke was coming from the grill.

It wasn't until a total of 8 firetrucks had arrived that the hungry customers realized they should consider other dining options and left.


A man in Zhangzou was hospitalized with fungal pneumonia. The potentially serious disorder has been attributed to his habit of repeatedly smelling his own socks after wearing them all day. He apparently did this as a way to relax after work.

I think I'll stick with a beer.


Mr. Onelio Hipolit-Gonzalez was arrested for running a bogus medical clinic.

He charged people $160 for an initial appointment, which consisted of them holding a metal rod that was connected to a beeping machine (Ah! the machine that goes "PING!"). Afterwards he'd tell them the machine showed various organ problems and that he could cure them for $2000.

His "cure" for diabetes apparently consisted of him drawing blood and then re-injecting it back into their body.

Mr. Hipolit-Gonzalez was reportedly "shocked" to learn his actions were illegal, and, as proof of his ability to practice medicine, stated he'd been a lab technician.


Mr. Abdias Melo, who must be a VERY sound sleeper, remained in dreamland while friends super-glued a colorful assortment of dildos to his back.

They then woke him by banging pots together.

Attempts to remove the dildos at home failed, and Mr. Melo ended up going to ER. I suspect even the most hardened team of emergency staff was taken aback by this case.

Either that or he was mistaken for a stegosaurus.

Thursday, February 21, 2019

A really sick horse

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

Mr. Patient: "My mother has smoked a pack a day for 70 years and, except for her lung
cancer and heart failure, is healthy as a horse."

Monday, February 18, 2019


You ever killed someone?

I have.

Of course, "kill" is too strong a word for what most doctors have done at some point, but still, he died because of my direct actions (a nurse and respiratory tech were involved, too).

He was a retired farmer, around 80. Strong and healthy for his age. I was in my early 30's, just out of residency and starting life as a newly-minted attending physician.

He'd fallen from a ladder and severed his upper cervical spinal cord. He was awake and alert, but completely paralyzed from the neck down. He couldn't breathe on his own, so was facing the rest of his life on a ventilator, requiring complete care for everything. There was no hope for recovery.

In the first days of the injury the trauma and neurosurgery people worked their magic, stabilizing what was left of his neck, converting him quickly from a ventilator tube to a tracheostomy for comfort, getting a feeding tube in.

As the days went by and we began decreasing his medications it became clear that he would live, was mentally intact, and could communicate with us.

In spite of what his family had told us, he wanted to be let go. He'd led a robust life and didn't want to spend the rest of it in this condition. He was ready to have things turned off so he could pass.

This sort of thing is (comparatively) easy in someone with advanced dementia, or severe brain trauma, or end-stage cancer. But in a guy who was fully awake and who'd been healthy and vigorous a few days earlier it was a whole different matter.

The family was unhappy, but acquiesced to him. To cover myself I had a psychiatrist interview him and ordered a consult from the hospital ethics committee. All agreed that he was pleasant, had a good sense of humor, and was fully capable of making this decision.

The family didn't want to be in the room when it happened, so we gave them all the time they needed to say goodbye.

When the time came we chatted briefly, and he thanked me and the team who'd taken care of him. He even asked that we shake his hand.

I had the nurse give him megadoses of morphine and Ativan, to put him to sleep and take away any pain that might still be there. Once he was out the respiratory tech disconnected him from the ventilator. Between the medications and his non-functioning diaphragm he went pretty quickly. I wrote a death note and moved on to another case. There are always more consults.

What would you call it? An execution? Physician-assisted suicide? Compassion? I'm sure some out there would love to have me tried for murder, but I don't care.

To me, my responsibility is to the patient. This man had lived a good life, wasn't suicidal in the sense of someone who's depressed, and made a rational decision about his own existence. I did everything I could to make sure there wasn't a good reason NOT to end his life, and did what I could to respect his wishes and relieve his suffering.

That was the first, though not last, time I've had to face this situation. We may become more experienced, but it never gets easier.

It's been 20 years, and I'd still say the same thing: In the end it wasn't my decision, it was his. I just did what was right for the patient.

Thursday, February 14, 2019

Neurology humor

Two neurologists were walking along the street when they saw an old-timer veteran cop walking a beat with his legs wide apart. He was stiff-legged and walking slowly. One doctor said to his friend: "I'm sure that poor old cop has Peltry Syndrome. Those people walk just like that."

The other neurologist says: "No, I don't think so. The old cop surely has Boyd Syndrome. He walks slowly and his legs are apart, just as we learned in training."

Since they couldn't agree they decided to ask the cop. They approached him and one said, "We're neurologists and couldn't help but notice the way you walk, though we couldn't agree on the syndrome you might have. Could you tell us what it is?"

The old-timer said, "I'll tell you, but first you tell me what you two fine upstanding neurologists think." The first doctor said, "I think it's Peltry Syndrome." The old-timer said, "You thought - but you are wrong." The other neurologist said, "I think you have Boyd Syndrome." The old cop said, "You thought - but you are wrong."

So they asked him, "Well, old timer, what do you have?"

The old-timer cop said, "I thought it was just a fart- but I was wrong, too!"

- Thank you, Officer Cynical!

Monday, February 11, 2019

Friday morning, 12: 38 a.m.

This message, left on the on-call emergency voicemail, woke me up:

"Dr. Grumpy, you can cancel all my appointments. I'm very hurt. This is the 2nd year that your lousy practice hasn't sent me a birthday card, like my dentist does. I think you're an asshole. Goodbye!"

Thursday, February 7, 2019

No kidding

Dr. Grumpy: "Are you allergic to any medications?"

Mrs. Ambu: "Succinylcholine"

Dr. Grumpy: "What happened when they gave you succinylcholine?"

Mrs. Ambu: "I stopped breathing."

Monday, February 4, 2019


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

Mr. Flurry: "Hi, I have an appointment later this morning, but am trapped at home by all the snow."

Mary: "I understand, we can certainly reschedule it for later this week, or next. What times of day work best for you?"

Mr. Flurry: "No, I'd really like to make this appointment. Isn't there some special doctor's line you can call or something, where they direct snow plows to my house and clear a route so I can get to the appointment?"

Mary: "No sir, there is no such phone number."

Mr. Flurry: "That's ridiculous. He's a doctor. Doesn't he know the governor, or mayor, or someone who can do that?"

Mary: "No."

Mr. Flurry: "This is stupid. I thought he was a good doctor, but obviously my appointments there have been a waste of time."

Thursday, January 31, 2019


Seen in a veterinary orthopedic course brochure:

Thank you, Webhill!

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