And now, music

Seen in a chart

This isn't the first time I've put up stuff like this, and it won't be the last.

But you know what? Crap like this is no longer the exception. It's the rule. I'd say at least 50%-60% of charts I read from hospitals and practices that use computer charting systems (which is pretty much all of them) have errors of this kind.

And these are what the world is pushing us to use more and more of.

I'm not saying computer chart systems are bad things. They have a lot of advantages. But they also encourage the slacker inherent in all of us. It's easier and faster to check boxes, cut & paste, and use templates than it is to actually type out what's correct. Especially if you skip the critical step of proofreading what you've just done. Most do.

The majority of these errors are just amusing. This one is just stupid, but likely won't cause a serious patient outcome.

But if it can make an error about smoking, it can also make them about your allergies. Your current medications. What conditions you have. Your past surgeries.

And one "minor" error in any of those could lead to a disaster in the right setting.

Cole slaw

I'm in the emergency room, talking to a patient's wife:



Dr. Grumpy: "When did this all start?"

Mrs. Concern: "Last night. He fell down in the bathroom, and said he couldn't move that side."

Dr. Grumpy: "Then what happened?"

Mrs. Concern: "I figured he was just angry at me, and trying to get attention. We'd had this big argument over cole slaw at lunch, because..."

Dr. Grumpy: "Okay, but last night..."

Mrs. Concern: "Oh yeah, anyway, so I watched some TV in bed - there's that new detective show I like - until I fell asleep. When I woke up this morning he was still on the bathroom floor, and boy, was he angry. So that was when I called paramedics."

New year's day

10 years

This post wraps up 2018. I'll be taking 3 weeks off, and will see you guys in January.


December 21, 2008, was, apparently, a slow news day. In looking backwards I really can't find any articles of note from the major news outlets on that date's happenings.

But to me it was a big day as I published my first post here.

A lot of factors had led up to it. For years I'd been collecting stories hoping to write a book... someday. But life, work, and kids get in the way of those things. At some point I realized the book was never going to happen.

Then, in 2008, a change in my practice led to me having a bit more free time. So, instead of a book, I decided to share my stories on this blog.

And here I am, 10 years out. My numbers have gone up and down, but I still seem to have a following. For that I'm grateful. If it wasn't for you guys there wouldn't be a reason to do this. My posts have dropped from twice daily to 2-3/week, but I'm still cranking them out and hopefully will continue to do so.

I appreciate those of you who have stayed with me and written comments. I've only been mentioned once in the general media, but knowing you guys are reading makes it worthwhile to keep doing this.

At 10 years out I want to thank my wife, for putting up with me, and my kids, who've grown from small rug rats to young adults heading for college since I started this.

I also want to thank Mary and Annie, also for putting up with me and supplying me with stories to share. Without you guys I wouldn't have a real job.

My patients deserve a big round of applause. Without them I wouldn't have this blog. Most of them are good folks, and I genuinely appreciate them making my job a fulfilling one. Medical blogs may give you the impression that most patients are insane, or stupid, or both, but that's far from true. The vast majority are good people, but stories of normal patient encounters are boring and aren't why you come here.

Lastly, I want to thank all of you guys for sticking with me over time, sharing your thoughts, and making this fun.

A special thank you is deserved by those I've met through the blog and who I'm now proud to call friends. We may never meet in person, but knowing you're out there is good enough for me.

Thank you all, have a great holiday, and I'll be back on January 14, 2019.

IG

2018 Holiday gift guide

Do you have a friend who's a dentist? Do you want to give your dentist something more meaningful than the gouges you leave on the arms of his exam chair? Do you know someone who simply has no sense of taste (me, for example)?

Then consider this cozy pair of pants:

Featuring an attractive pattern of molars and bicuspids in alternating red and white (I guess the color depends on whether you remembered to stop taking warfarin before your root canal), these pants are ideal for visits to the dentist, holiday parties, and any job you're hoping to get fired from.

2018 Holiday gift guide

Those old enough will remember Rockwell's 1980's hit "Some Random Guy is Watching Me."

Wait? That wasn't the title? Never mind.

But if you have a friend who has delusions of that sort, you can order this for them:

The "Old Asian Man Wall Decal" (seriously, that's what it's called) is available from a number of websites for people wanting to add it to their home's atmosphere. Or something.

2018 Holiday gift guide

Do you have a friend who's trying to attract the perfect guy, hoping her perfume will do the trick?

Maybe you should get her this:

Let's face it, nothing gets a guy's attention like a woman who smells like a slab of roast beef. Or an Arby's.

If nothing else, she'll certainly have the attention of every dog in the neighborhood.

Saturday morning

Frank got home from his first college semester last night.

This morning, Mrs. Grumpy and I were woken from a sound sleep by screaming and loud noises.

Apparently, at around midnight, Frank couldn't sleep and set up his laptop to work. He'd forgotten the password for our home WiFi network. Instead of, say, waiting to ask someone in the morning, he just wiped the router and changed the passwords.

This morning the twins discovered what had happened, and went bananas when they couldn't get online. His door was locked, and when they couldn't wake him up, Marie and Craig kicked his door in.

Now Frank is upset we woke him up on his first day of break.

I'm taking the twins' side.

2018 Holiday gift guide

Do you have a friend who thinks he has animal magnetism? Maybe these boxers are the perfect gift:

Available from Newchic, this pair of boxers has a series of magnets sewn into the vital package-support area. The website makes claims about this boosting the immune system (it doesn't say if they specifically mean against STD's), "releasing energy," (if my winkie was glowing that color, I'd be pretty worried about the energy source) and (my favorite) improving the body's oxygen supply.

Plenty of guys, myself included, have been accused of thinking with our male appendages. To date, however, I've never been accused of breathing through it.

Isn't that right, Mr. Snuffleupagus?

2018 Holiday gift guide

Mattel, the company that brought you Barbie, Hot Wheels, Masters of the Universe, American Girl, Polly Pocket, and Matchbox, now brings you its next big seller.

And... I'm going to have to let these ladies describe it, because I couldn't possibly do a better job.

Please note, this is not a joke.

2018 Holiday gift guide

Like most medical students, you're tired. You just finished class and want to crash out on the couch. But you've also got a big test tomorrow and need to study. What can you do? Hey, I've been there myself.

You can hit the textbooks, or you can study planted on the couch if you have this human anatomy throw pillow!

What better way to get some studying done, or liven up a dinner party, than with this useful pillow cover? (Sorry, folks, the pillow isn't included).

To quote from the product description:


"Makeover and refresh your rooms with just a single touch!"

"Perfect for your home, office, playroom, kids room, cafe, study, studio, club, bar and others."

"No dye substance harming the health of you and your family."

"A perfect gift idea for your mom, dad, sister, brother, grandma, wife, husband and all other beloved ones."

"They will be shocked by the superior quality of the item when they open the present."

"We follow current trends and bring you the latest home fashion."

"A gift to your family or friend, relative or boyfriend girlfriend, or to yourself, the item should be interesting and authentic."


It most certainly is.

2018 Holiday gift guide

Do you have a friend who needs some absolutely pointless piece of furniture? Do you have an extra $12,000 you'd like to blow?

Then this is perfect!

Why have a routine sofa that takes up horizontal floor space, when this one stands vertically?

Yes, you could take the regular sofa you already have and stand it on it's side, but what's the point? This one already does that!  Instead of getting some piece of schlock that does nothing but let people sit on it, you can have one that serves absolutely no purpose other than to say you can afford it! And isn't that what home decorating is all about?

Joe and Al

Joe and Al are both patients of mine.

They don't know each other.

They were born in the same year, a few thousand mild miles apart, speaking different languages.

To most who meet them they come across as polite older gentlemen, each with a good sense of humor. They may notice Joe's tremor or Al's speech difficulties, but neither is a major part of who they are.

But to me, they mean a lot after 20 years in practice.

Joe was born in Poland. His father was a tailor, and Joe worked in the store growing up. Because they were Jews, the family business was closed by the government so they had no way to support themselves. He saw his father beaten to death for trying to keep the family together while boarding a train. His mother was put in a different train car and never seen again. His sister was forced to work in a brothel for German officers and was never seen outside that building again. He and his brother were together until they got to the camp sorting area. His brother, who had a bad cough that week, was sent to a gas chamber. Joe was sent to do slave labor, and was still alive when the camp was liberated by allied forces. Joe, at 5'10" weighed 94 pounds by that point, and was hard to distinguish from the dead bodies he'd been forced to carry outside.

After recovering in a military hospital, Joe decided to leave Europe forever. He immigrated to America, settling in Omaha. He went to school, married, raised a family, and spent most of his life in a quiet, unassuming, desk job. Today he's nearly blind and needs a walker to get around. His wife is still at his side, and sometimes one of his kids.

Al was born in Los Angeles. He worked in a grocery store and went to high school until he turned 18, when he was drafted into the Marines.

On the morning of February 19, 1945, he was roughly 6,000 miles from L.A., in landing crafts with 60,000 other Marines, approaching the peaceful-appearing sands of Iwo Jima in the south Pacific. As they clambered ashore and gradually moved inland it was surprisingly quiet, with none of the resistance they'd encountered on previous islands.

About an hour after coming ashore, that all changed. The well-hidden Japanese forces opened up on the beach with machine guns and heavy artillery, creating a hell-on-earth. There was nowhere to hide. Al saw guys he'd had steak & eggs with a few hours earlier (the standard U.S. Marine breakfast for landing forces) collapse around him, dead. Some were wounded, and he and others tried to get them to whatever safety they could find. Then he was hit himself, but worked to help others until he blacked-out from blood loss. He woke up on a hospital ship.

After the war he returned home, finished school, and managed grocery stores until he retired. He and his wife raised a boy and 2 girls. They recently celebrated their 60th anniversary. Today he uses a walker and oxygen tank, and is nearly deaf, but still has a hearty laugh.

At this point both are in their 90's. The horrors they experienced aren't forgotten, but hidden behind a lifetime of mundanity (which, lets face it, mundanity describes most of us, and it isn't a bad thing).

In my mind they're bound together by being (most likely) the last of their kind I'll meet.

I've seen my share of Holocaust survivors, but as the years go by they've decreased, and I doubt I'll meet another after Joe.

Similarly, in 20 years I've cared for plenty of WW2 veterans, but see them grow fewer, and the odds are I won't meet another who fought at Iwo Jima.

Like many of their generation, neither wants to talk about what they went through. The memories are painful, and both men would rather be defined but what came afterwards: their families.

But they, and what they went through, shouldn't be forgotten.

Ever.