Monday, April 6, 2009

Torturing Your Child

So, Grumpy fans, a catalog of various medical supplies showed up in today's mail (addressed to "Physician Occupant" no less).

It included this remarkable device. According to the caption, the purpose of this thing is to "comfortably help children sleep" who have breathing problems when lying on their backs.

I don't know about you guys, but I can't see how any of my kids would "comfortably" lie face down in this thing for more then, say, 5 seconds, unless I used duct tape to hold them there.

(click to enlarge)

Why are my prescriptions so expensive?

There are a lot reasons drugs are so damn expensive, gang. I'm sure research & development are most of it, but some of it is because of sheer stupidity and waste on the pharmaceutical company's part.

Case in point: If you remember, I spent a February weekend in LA at a drug company meeting, and they asked me to bill them for my expenses. So I sent them my receipt ($32) for airport parking.

I got my $32 check today. It was sent by FedEx priority overnight delivery from Philadelphia.

The cost of sending me the check was $10.55.

For the record, I didn't ask for emergency delivery. I would have been happy with a 42 cent stamp.

More Stupidity

Ok, gang, I just had to post this link. This is amazing. A woman who called 911 because she couldn't figure out how to open her own car FROM THE INSIDE!!!

Check it out!

Friday, April 3, 2009

Ride 'em Cowboy!

One of my back pain patients came in today. Showed me the new massage device he's been using for his pain, with great success.

It was HUGE. The size of 2 car batteries side-by-side. And heavy. And when he plugged it in and turned it on it sounded like a freaking lawnmower.

I asked him where he got it, and he said he saw it being used at this year's Arabian horse show. It's made to massage horses. He bought it from a trainer.

It actually had a label on it that said "NOT FOR HUMAN USE".

Thursday, April 2, 2009

Idiots Among Us

I got the greatest call from a pharmacist today. Here's the story:

On September 15, 2004 I saw a lady for low back pain and gave her a script for Percocet.

For whatever reason, she never had the script filled, just shoved it in a drawer at home. She never followed up with me.

Yesterday she apparently found the script buried in the drawer, and decided she should get it filled. She figured (correctly) that the pharmacy wouldn't fill anything that was written 5 years ago.

So she changed the date on it to September 15, 2009, and took it to Walgreens.

The pharmacist who called me was laughing so hard he was crying.

Tuesday, March 31, 2009

Say that again?

This is a gem. From a new patient today, that I was getting some family background on:

Dr. Grumpy: "Any history of miscarriages in your family?"

Mrs. Notsobright: "My Mom had one, with me."

Monday, March 30, 2009

No, You Idiots. I Treat Dead Patients, Too.

Check this out, Grumpyites. This is a form I have to fill out every few months for patients to continue receiving a drug called Tysabri.

I direct you to question #1: Is the patient still under your care?

IF I answer "yes" to that question, THEN (in question #2) I'm asked if the patient is alive!

How much do you think they paid the bozo who wrote this form?

(click to enlarge)

Sunday, March 29, 2009

True Love in the ICU

Hi, grumpy fans. Your hero was on call this weekend.

This morning I was called to evaluate a 23 year-old female who was found
floating face down in her pool. Probable suicide attempt, with brain damage.

While I was writing my chart note a nurse came over to tell me that the
patient's fiancé was on the phone, and wanted to talk to a doctor about
what was going on. I picked up the phone and had the following
conversation:

Dr. Grumpy: "Hello?."

Mr. Fiancé: "Yeah, are you the doctor taking care of my fiancé, Jane Doe?"

Dr. Grumpy: "Yes sir, what can I do for you?"

Mr. Fiancé: "Are her car keys there? 'Cause it's my car, and I need it back."

Dr. Grumpy: (astounded) "No sir, there aren't any car keys here."

Mr. Fiancé: "Well, did she leave a note saying where the car keys were, or where she left my car parked? I need it, because I have stuff to do today."

Dr. Grumpy: "No, sir, nothing like that"

Mr. Fiancé: "Well, you're no help to me" (hung up the phone).

Tuesday, March 24, 2009

You people drive me nuts!

So the Friday before leaving on the cruise I saw this guy for back pain. Since I manage my own patients no matter where I am, I had to deal with him all week on my trip.

He wanted an urgent MRI (his request, I didn't feel it was medically urgent). So the weekend after his Friday appointment he called my closed office 5 times to see if we'd scheduled it yet (sorry, sir, your crappy HMO hasn't opened their authorization department on a weekend just to accommodate you). But on Monday, my nurse, who can work miracles, somehow got an authorization expedited just to shut him up.

So we got the MRI mid-week. I personally called him Friday afternoon from the cruise to go over his benign results. He demanded that I do "Something! Anything! Just fix me!" (for the record, sir, doing so is beyond the skills of the best psychiatrists). So I told him I'd order physical therapy.

So this past weekend, apparently forgetting that Crappy HMO, Inc., isn't open on weekends, he called 3 times to see if his physical therapy had been set up yet.

My secretary called him Monday morning to schedule his physical therapy. He told her that he'd decided at the last minute to go on a 3 week trip to visit some old college buddies in Idaho, and would call us when he got back.

Sunday, March 22, 2009

Back to the Salt Mines

So within 48 hours of me getting home, I got dragged in to the hospital. One of my office patients had a stroke on a weekend. Can you believe the nerve? They should schedule this sort of thing in advance.

Anyway, I wandered into the doctor's lounge, where the TV was off. This is a remarkable event. The TV in there is ALWAYS on, usually turned to CNN or ESPN or MSNBC.

So the giant TV is quiet, with a little sign taped to it that says "The cable box will be fixed on 3-23."

In spite of this, there were 3 (count 'em! 3!) docs sprawled across chairs in front of the electronic deity, just as if it were on! Staring at the blank screen, and occasionally mumbling to each other how they wish it would be fixed today!

Does this seem odd to anyone else out there?

Friday, March 20, 2009

Cruising with Dr. Grumpy, #6

(It’s Spring Break! We are taking advantage of recession rates to take our brood on a Mexican cruise. So you guys can now enjoy a week of relatively medical-free posts, with me blogging from the ship).

Friday

At sea, going in slow loops back toward LA. Today was our last day on the S.S. Buffet.

After breakfast I entered a trivia contest (I won). It was run by the activities director, who kept misplacing things and forgetting questions. At one point I jokingly said, "I'm a neurologist, let me give you my card", and the crowd laughed. After the contest she cornered me. Said she had epilepsy, wanted to know what I thought of Depakote. That will teach me to keep my mouth shut.

You know it's time to go home because the amount of water you displace getting into the hot tub is a lot more than it was on day 1 of the trip. And those hot college babes in tight thong bikinis? After 7 days of nonstop meals they don't fit into their bikinis very well, and are now the size of shipping hazards.

A phenomenon you see on the last day are these forlorn 16 year old couples wandering around, holding hands, or staring into each other's eyes over a Diet Coke on the Promenade deck. They never knew each other until a few days ago, and now they feel like here, on a cruise ship, they've met their soulmate, and can't bear the thought of going back home to their respective home towns of Slotmachine, Nevada and Los Taquitos, California. And in 2 weeks they'll have a vague memory of each other, "oh yeah, this is a picture of whathisname, that guy I met on the cruise"

Why does every issue of the daily newsletter "Cruiseline Capers" list the captain's name on it? It's not like it should be changing from day to day. Is this to reassure you that there was no mutiny overnight? If there was, would they put the new captain's name on the newsletter ?

After a round of mini-golf Marie and I went up front to look over the bow. Occasionally you'd see a dolphin leap up, or rarely a whale surface and blow air. She, unfortunately, has now decided that EVERY whitecap on the ocean is a dolphin or whale. So when she sees whitecaps (which is often) she begins screaming that she sees a whale or dolphin. Mrs. Grumpy and I have learned to ignore her, but when she does this so many other passengers drop what they are doing and rush over to look that you expect the ship to tilt.

To wrap up our last day, we went to a comedy show in the main theater, where they were just finishing a round of Bingo. They were trying to get 5 numbers in a row. We all know how to play bingo. Apparently, it's simplicity is beyond the IQ of a lot. We would see people jump up and yell "Bingo" and start screaming wildly. So the person in charge would wander back to find they only had 2 or 3 out of 5 numbers in a row. This actually happened quite often. How stupid can you be? Or were they hoping the director would say, "hey, you only got 3 of the 5 numbers, but since you were willing to jump up and make an ass out of yourself we'll give it to you, anyway."

The day concluded with an excellent dinner, but by this point we were getting tired of food. You find yourself looking at the menu of prime rib and lobster and want to ask for a big bowl of Kellogg's Colon-Blow cereal instead.

So, from somewhere off Baja Calfornia: Merry Spring Break to all, and to all a good night.

Thursday, March 19, 2009

Cruising with Dr. Grumpy, #5

(It’s Spring Break! We are taking advantage of recession rates to take our brood on a Mexican cruise. So you guys can now enjoy a week of relatively medical-free posts, with me blogging from the ship).

Thursday

Today the S.S. Buffet was in Cabo. Our last 2 excursions off the ship (see last few posts) were just so much @#$%!!! fun that we decided to just stay on board.

On the way to breakfast this morning I passed a cabin with a sock over the door handle. I had no idea guys still did that. It was quite nostalgic. Last time I saw that signal was when I lived in a dorm at BSU (Big State University) in 1985. In this day and age I guess I'd figured guys had developed a more technologically advanced way of saying "do not enter, I am scoring" (or at least trying to make others think you are).

It was comical, especially when 9 year-old Frank asked me why there was a sock on the door (I told him they needed laundry done). I briefly toyed with the ideas of exchanging it with the "maid service please" sign on another door, or even going to the ship's store and buying a whole package of socks to put on every door along that hall to make it look like some sort of humpfest was in progress.

There is actually a lady, I swear, who brought a FUCKING SCALE on the ship. She weighs herself BY THE POOL every morning, and loudly announces her current state of chubbiness. Since the numbers keep going up, I can only assume she is looking for a sympathetic response. But no one else responds. I think they're all afraid she'll offer to weigh anyone who speaks up.

In the afternoon I started playing cards with Craig and Marie by the pool. They became indignant, feeling that since they'd seen a room labeled "card room" downstairs, we shouldn't be playing cards anywhere else. In fact, both were concerned security would haul us away for even having possession of a deck of cards anywhere but a designated card room.

So we went to the card room. There was one family playing bridge, and a group of blue haired elderly ladies playing Mahjong. Craig immediately went over to inform the grandma club that it was the card room, and they could get in trouble for playing non-card games.

I hurriedly grabbed an empty table, dragging Craig away from theirs. I sat down to play steal the bundle with them. I had my back to the wall, and the twins were facing me. Unfortunately, in my hurry I hadn't noticed I'd sat down beneath some 17th century painting of the roman god Mercury, wearing nothing but a hat. So Marie suddenly shrieked "Look! You can see his penis!" Then they both began cackling hysterically.

At this point I began getting some icy glares. So I gathered up the cards and kids, mumbled an apology to the Mahjong League of Death, and ran out.

The day wrapped up with a party for past guests, which involved free drinks, so I had several. There were also hors d'ouvres. A pleasant young wattress kept coming by our seat with a tray of things (it was too dark in there to see what). When queried she said "They’re chili fish". I had no interest at all in them, and said no. So she put one on my plate. As soon as she left I quickly moved the plate to an empty table, so she immediately came back to offer me another chili fish. This time I apparently managed to communicate my complete lack of interest, and she pleasantly wandered off, only to return 1 minute later to ask me if I'd like a chili fish.

At this point the orchestra announced they were opening up the floor for dancing, so again Marie dislocated my shoulder to drag me onstage. Muttering a silent prayer that none of my patients were watching, I went up again. So we danced in front of 500 or so past guests. At one point Marie lost her balance and grabbed my shorts for support. Unfortunately, I was wearing shorts with an elastic waistband and no belt. Miraculously, I grabbed them just before they were lowered too much, sparing the past guests a view of my undies and possibly reasons to try another cruise line.

So we went back to our seat, and a cruise photographer (his name is Whackjob, I swear) immediately came over to get a picture of Marie and I. He fired a trillion megawatt flash at me from point blank range, blinding me for several seconds. All I could see was a bright light surrounding me, and briefly wondered if I'd died. I quickly realized I'd done no such thing when a voice through the blinding light suddenly said "Chili Fish?"

I really like cruising. Too bad the lines aren't interested in having the services of a neurologist on board. Maybe they could have a stroke-themed cruise ("you're planning on having a stroke, sir? Well, on Cruiseship Lines we have a special ‘stroke at sea’ cruise, featuring an on-board neurologist and MRI").

Any interested cruise lines please email me.

And that's the way it is.

Wednesday, March 18, 2009

Cruising with Dr. Grumpy, #4

(It’s Spring Break! We are taking advantage of recession rates to take our brood on a Mexican cruise. So you guys can now enjoy a week of relatively medical-free posts, with me blogging from the ship).

Wednesday.

Today we were in Mazatlan.

The view from our cabin, surprisingly, was different today. Instead of looking straight down into water (which we'd been doing since boarding the ship) we were looking straight down onto concrete. I could only assume we were in port or had had a serious navigational mishap.

My first view of Mazatlan, out the window of the dining room at breakfast, was a giant cement dock covered with such attractive things as mountains of rotting rubber tires, rusting freight containers, and billboards that said "eat at Senior Frog's"

As we ate, a band of about 20 musicians showed up to play at the gangway. Most were obviously hung over. They were pleasantly off key and unsynchronized, and at one point a trombone player tried to do some sort of spinning dance move and fell over, knocking over 2 other musicians in the process. This only improved their playing.

There were a few small shops inside the port area, to allow tourists the pleasure of buying cheap marionettes without having to travel into the city. Mrs. Grumpy and I decided to incarcerate the kids in Camp Cruiseship, and go out there. At some point, for unclear reasons, she decided we would take an “air-conditioned comfort trolley tour” of the city. The guide said it was a 2 hour drive of the city's highlights (which turned out to be quite a lie, sort of like Gilligan's 3 hour tour).

They wanted $25 per person, so she paid the guy cash, and he said he'd come back with our tickets. He then disappeared, and I assumed that was the last we'd see of him and our $50. Surprisingly, he showed up again a few minutes later, and gave us our tickets. He also told us the tour included all the beer, pop, bottled water, and margaritas we could want. So off we went.

The "air-conditioned comfort" trolley turned out to be a diesel bus without working air conditioning. It was 97 degrees outside with 98% humidity. The comical part was how the driver and tour guide (Fernando) both kept insisting the air conditioning was working fine, in spite of remarkably obvious evidence to the contrary (like the fact it was a frigid 99 degrees inside the bus). In fact, they insisted on keeping the windows closed to help improve the efficiency of the nonexistent air conditioning.

The free drinks, as it turned out, were NOT on the bus. The bus dropped us off to "explore the local culture" (which consisted of several large diamond and silver stores), where they offered bottled water from a local municipal source, thimblefulls of beer, and margaritas made with Fresca & Tequila (I swear!). One place had Diet Coke, which I asked for. I discovered that Mexican Diet Coke has a unique flavor enhancer, namely aluminum foil, added. I left the can on the counter. I went to take a leak (I considered drinking my urine as a survival tactic, since I at least know where it came from), only to discover that the toilets were of the robust kind that can't handle toilet paper. So there's a big wastebasket full of used TP next to the potty.

Outside the store was a cart selling ice cream, with a sign listing the flavors in English. They included "cheese" and "burned milk" ice creams. Mmmmmmm.

As I'm writing this by the pool, the ship's calypso band has just started a reggae version of "Sweet Caroline". These cruise lines REALLY need a policy limiting the number of times the pool band can play "Red, Red, Wine". And perhaps banning reggae versions of ANYTHING by Juice Newton.

Anyway, then we were driven along a beach, where the locals have built monuments to all things of importance in Mazatlan. I am not joking. There was a large statue of a shrimp, another of a taxicab (I swear!), and even one of a beer-brewing tank. All they needed was a memorial to the unknown tourist, who died in a van without functioning air conditioning.

At one point we drove past a decrepit building, which looked like an earthquake trashed it, with a sign over the door "Dr. Gonzales. Neurologico". I will never criticize my tiny office again. We also saw several realty signs, advertising homes for sale by Jesus. I won't say anything more.

Oddly, there is only 1 Senor Frogs restaurant there, but 8 stores selling "eat at Senor Frogs" merchandise. WTF?

The drive back to the ship was somewhat comical, as the guide announced that while we were in the last diamond shop the van's air conditioning had suddenly broken. I am not joking. He was sorry, but not sorry enough to refund money, or even admit it had been broken all day (or possibly since 1987). To help keep us cool he opened the windows AND the large folding doors he was standing next to. So we were speeding down the highway with Fernando leaning against the open door frame and talking into the microphone. I'm sure if we hit a bump we would have heard some interesting, though brief, Spanish phrases on the intercom. From what I can tell of local driving, a traffic accident doesn't qualify unless a minimum of 1 limb is severed.

Seeing the S.S. Buffet in the distance, dwarfing all the buildings in Mazatlan, was a beautiful sight at this point. After getting off the bus Mrs. Grumpy had to restrain me from causing an international incident with the tour company. We were glad to get back to sea.

I took Marie and Frank up to mini-golf. We were in a crowded elevator, and I asked them if they wanted to stop for ice cream on the way to the course. Marie said, "no, I have a stomach ache. But it's not as bad as when I was camping with Grandma and got diarrhea." Then, trying to be helpful, she turned to the middle-aged lady behind her and explained "diarrhea is when you have to poop a lot."

Playing miniature golf with Marie is difficult, because she usually hits the ball off the course, and occasionally the ship. She often hits other passengers. I then reprimand her for hitting the ball too hard and striking someone. So she starts crying so pitiously that the wounded person will come over (still holding an ice bag on their head) and say "It's okay, honey, it didn't hurt that much" or "I'd broken that ankle before, anyway".

And that's the way it is.
 
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