Thank you for this interesting consult

Actual chart note I saw on Friday:


"Patient has history of Alzheimer's disease. Currently has obvious memory deficits. Will consult neurology to see if they can find a cause for his memory loss."

Broadcast journalism

Yes, folks, this actually aired today on California TV station KTVU.






They've since apologized, and both they and the NTSB are blaming the error on an unidentified "summer intern."

Patient quote of the day

From a retired surgeon:

"I had surgery for osteomyelitis as a kid. We didn't have all that fancy antibiotic shit they do now."

Fun with Mary

Sometimes an annoying patient won't take no for an answer.


Mr. Pest: "So, Mary, can we get together this Saturday?"

Mary: "No, thank you. I have plans."

Mr. Pest: "Come on... we'll have fun."

Mary: "I'm not interested, sir. I have a boyfriend."

Mr. Pest: "You could still go out with me."

Mary: "Okay, how about you and I take a drive over to Southtown this weekend? Could you pick me up?"

Mr. Pest: "Sure, but Southtown? By the prison? That's a terrible area. Why do you want to go there?"

Mary: "My boyfriend needs a ride home. He's being released on parole."

Mrs. Grumpy agrees

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

Nurse Newbie: "Hi, I'm the nurse taking care of Mr. Harry Plegia, in room 842."

Dr. Grumpy: "What can I do for you?"

Nurse Newbie: "Well, there was a consult written for you to see the patient 3 days ago, and we never heard back from you. I was wondering if you'd even gotten it, and when you'd be by to see him?"

Dr. Grumpy: "Um... I did the consult 3 days ago. And I've been following him daily since then."

Nurse Newbie: "Really? Because there was a family member here about 2 hours ago, who was looking through the chart, and told me he wanted to get another MRI. I don't know how he got the chart. Anyway, I called the hospitalist, and he told me to run it by you."

Dr. Grumpy: "Two hours ago? That was me! I came over and told you I wanted to do another MRI, but the computer ordering system was down when I tried to put it in."

Nurse Newbie: "That was you? Not a family member?"

Dr. Grumpy: "Yes!"

(pause)

Nurse Newbie: "Doctor, you really should dress better."

Pulp

Miss Print: "Hello, Throwaway Rags, can I help you?"

Dr. Grumpy: "This is Dr. Ibee Grumpy. You guys shipped me a huge box of magazines for my lobby."

Miss Print: "Let me see. Yes, you're on our list to receive 50 copies a month."

Dr. Grumpy: "I didn't order them, and I don't want them. Please take me off the list."

Miss Print: "Have you looked through our magazine?"

Dr. Grumpy: "Yes. It's 90% paid advertising, extolling the virtues of Wirth-Liss Pharmaceuticals overpriced medications."

Miss Print: "Well, Wirth-Liss Pharmaceuticals is paying for every neurologist to receive 50 free copies to share with your patients. Education is important. You can place them in your lobby."

Dr. Grumpy: "I don't want them in my lobby. I put them in the recycling. And I don't want to get anymore."

Miss Print: "You're depriving your patients of an opportunity to learn about their treatment options."

Dr. Grumpy: "I'm not going to argue with you. Either cancel my subscription, or let me talk to your supervisor."

Miss Print: "I'll cancel it. But you're really doing a disservice to your patients. They deserve better."

Phonetics

In the mid-2000's there were several government hearings concerning the safety of the COX-2 family of drugs (Vioxx, Bextra, and Celebrex).

A colleague of mine was working for the FDA at the time, and had to sit through hours of testimony on them. He sent me this remarkable e-mail after one:

"Today we had a military doc testify. He told us that the drugs are important in military use, because they can get injured soldiers back into battle sooner.

"He finished his speech by declaring 'Soldiers need COX-2!'

"And that just doesn't sound good when spoken."

Great copywriting moments

"Maybe an orthopedist would be better?"

Source: Here.


Thank you, M!

Footprint?

I'm not sure what to make of this.

This fan-shaped area of flattened grass wasn't there when we left yesterday morning, but it was definitely there when we got home late afternoon. It looks like a giant footprint:

Mello investigates

Anyway, if your pet therapod has escaped somewhere in Grumpyville, I think it was in my backyard today. Hope that helps.

Thank you for sharing

Mary: "Okay, I'll let Dr. Grumpy know you're here, and he'll take you back in just a minute."

Mrs. Knickers: "Do you have a bathroom I can use first?"

Mary: "Sure, it's that door to your left."

Mrs. Knickers: "I need to change my underwear. You wouldn't believe the drive I had here."

Fiat lux

Dr. Grumpy: "Let's go to my exam room..." (walks into exam room, flips on lights)

Mrs. Photic: "OH MY GOD! DID THE LIGHTS JUST FLICKER?!!!"

Dr. Grumpy: "Uh, I think so, when I turned them on. They're fluorescent."

Mrs. Photic: "THIS MEANS SOMETHING!"

Dr. Grumpy: "Everything is fine, ma'am. It only means they're on. Have a seat over there, and let me take your blood pressure.."

Mrs. Photic: "They're not going to flicker again, are they?"

Dr. Grumpy: "I don't think so, but they're old fixtures."

Mrs. Photic: "If they do, I'm leaving. For all I know you're one of them."

Um, okay, you can call it that

Frank & Craig were at sailing camp on Lake Grumpy yesterday.

This picture was in the "Sailing Instructions" pamphlet they were given.

Immature? Why yes, I am!

History reruns

June 30, 1908.

One of the most remarkable events in history happened on this date. And it's mostly forgotten.

At 7:14 a.m. a MASSIVE explosion occurred near the Tunguska river in Russia. I'm not exaggerating. The force was somewhere between 5-30 megatons. Think about that: an explosion between 150 to 1000 TIMES the power of the Hiroshima nuclear bomb. And it happened 37 years before the nuclear age began.

And, purely by chance, it happened in a fairly uninhabited part of the Earth.

To this day its exact cause is unknown, and it's simply called "The Tunguska Event." It's generally believed to have been a meteorite or comet that exploded before hitting the ground.

The shock wave it sent through the ground was a 5.0 on the Richter scale. Every tree in an 8 km (5 mile) radius from the center was killed, and the force of the explosion covered a total of 830 square miles (2,130 square km). An estimated 80 million trees were knocked over by the force- all of them pointing away from the center. A few were left standing, scorched black, with all their branches stripped off. People were knocked off their feet, and windows shattered, hundreds of miles away. The pressure wave was measured as far away as England. For the next several months there was a change in the density of the planet's upper atmosphere.

An eyewitness 40 miles south of the explosion, reported that "At breakfast time I was sitting by the house at Vanavara Trading Post, facing north. I suddenly saw that directly to the north, over Onkoul's Tunguska Road, the sky split in two and fire appeared high and wide over the forest. The split in the sky grew larger, and the entire northern side was covered with fire. At that moment I became so hot that I couldn't bear it, as if my shirt was on fire; from the northern side, where the fire was, came strong heat. I wanted to tear off my shirt and throw it down, but then the sky shut closed, and a strong thump sounded, and I was thrown a few yards. I lost my senses for a moment, but then my wife ran out and led me to the house. After that such noise came, as if rocks were falling or cannons were firing, the earth shook, and when I was on the ground, I pressed my head down, fearing rocks would smash it. When the sky opened up, hot wind raced between the houses, like from cannons, which left traces in the ground like pathways, and it damaged crops. Later we saw that many windows were shattered, and in the barn the iron lock had snapped."

There have been other impacts in recorded history, but none this powerful. And, over 100 years later, the scars are still there.



1921: 13 years after the event.







2008: 100 years after the event.


And, just remember: we live in a solar system full of flying objects.

Dear Mrs. Soda,

Please do not leave a message that you changed your mind and want to take a medication.

And, when we call you back 20 minutes later, say that you changed your mind again and now you don't want anything.

Then call just after closing to say you've changed your mind again, and would like me to call something in.

And not have a pharmacy number, or even know what pharmacy you want it called too, when I dial you back.

Then yell at me for not knowing which pharmacy accepts your insurance.