You, YES YOU, are an Idiot

Thank you for coming in on this lovely Friday afternoon, ma'am. I guess you called around 1:30 today, and since we didn't have a 4:00, which is my last slot of the day, my secretary Mary put you in. Let me just open another Diet Coke, and we'll get started.

So you've had headaches for the past 20 years? And never seen a doctor before for them? What made you come in today, of all days, for this? Oh, you did a Google search.

Thank you for this printout of all the horrible types of brain tumors and aneurysms that can cause headaches and kill people. I appreciate it, because as a board certified neurologist with over 10 years of experience I really have no idea what sorts of things can cause headaches.

If you'd read it you might have noticed that the average survival from these awful things is 1-2 years, not 20. But I'm sure you're busy and didn't have time to actually read the articles you were printing up. After all, you had your hands full calling every neurologist on your insurance plan trying to find one who still had openings on this lovely Friday afternoon.

Of course we can get an MRI. I understand it would make you feel better, and allows me to cover my own legal butt, too.

Oh, you're claustrophobic? No, an MRI is really the best test we have right now for evaluating this sort of thing. I'm sorry that Reader's Digest somehow gave you the impression that I had a gadget in my office I could wave over you to make sure everything is okay, but I don't. Dr. McCoy borrowed my tricorder a while back and hasn't returned it yet. But we can do the MRI with Valium to relax you, if such a thing is possible.

I'll have my staff schedule the test for next week. No, I'm sorry. It's now 4:00 on a lovely Friday afternoon. Your insurance company requires an MRI request to be approved by a panel of dart-throwing chimpanzees before agreeing to pay for one. All of their offices are in another time zone, and have closed by now on this lovely Friday afternoon.

You really feel you need it immediately? Then the only thing I could suggest would be to go to an ER, and tell them you need an MRI right now. I'm sure, that after hearing your story and realizing how urgent this is, as opposed to a guy with chest pain, the ER doc will be happy to waste (uh, I mean spend) time and money on your case. Just don't tell him that I'm your doctor.

Oh, I had no idea your ER co-pay was so high. $50 does seem a bit extravagant for a lady with diamond rings on every finger and Porsche keys hanging out of your LV purse. I certainly can understand your refusal to go there.

Then it will have to be next week. My staff will call your insurance first thing Monday morning to get this authorized and scheduled.

Your insurance coverage runs out at the end of this month? My calender shows that today, May 29, is a Friday (which is a lovely afternoon by the way) and the last workday of the month. So Monday will be June, and we won't be able to get the MRI from your current insurance then, since it will have run out.

What insurance will you have on Monday? I'm sorry, I'm not contracted with that plan. I can send your internist a letter asking him to order the MRI. Oh, he's not contracted with it either. I see.

Yes ma'am, I agree it was entirely unreasonable of Mary to not have foreseen that you'd be changing to an insurance I don't take next week. You didn't mention that to her when you called for this appointment a few hours ago, but she really should have known, anyway. I'll discuss her suboptimal psychic powers with her at her next job evaluation in 2018.

I'm sorry you have to go already. Well, try to take it easy over the weekend, and I'll send my records to a neurologist on your next insurance, so they can help you out.

Going to a hockey game tonight sounds like fun, and it's great that you have such good seats. That looks like a nice air horn in your purse. I'm sure that sort of quiet, relaxed environment will help improve your headaches in the meantime. Thank you for sharing this lovely Friday afternoon with me.

Drug Rep From Hell

I like most of my drug reps. I'm sure many medical people will be horrified at me saying that, but it's true. Most of them are decent people, working hard to support their families, just like I work hard to support mine. They have their job and I have mine. No, I'm not getting TV's, trips to Tahiti, or even a cheap pen to say that. It's just true in my experience.

HOWEVER it only takes a few bad ones to give them all a horrible name. I've had my share of bad ones. My current nightmare is Rikki Phoneysmile, who works for Giant Pharma, Inc. This company is known for teaching it's reps to be aggressive and obnoxious, and quickly eliminates reps who actually try to be friendly and well-mannered.

Rikki is a serious pain in the ass. My staff knows to not even ask me if I need anything from her. They just tell her I need none of her samples, and to go away. I keep hoping that if she goes long enough without my signature Giant Pharma, Inc. will demote her to their farm team at the used car lot.

Anyway, today Mrs. Grumpy e-mailed me to get some tomatoes on the way home (off the subject, I have no idea where all these tomatoes are going. She has me pick up tomatoes all the damn time, and I've never seen one on the dinner table in any form). So I stopped at the grocery store.

I'm standing in produce, fondling the tomatoes, when I'm suddenly assaulted by Rikki Phoneysmile! Out of the blue, she's suddenly in my face, between me and my tomato, extolling the virtues, mechanism of action, and low incidence of adverse effects seen with Flatulata, the latest unneeded product from Giant Pharma, Inc.

Rikki has actually, I shit you not, left a shopping cart with 2 small children (oh crap, she's breeding) and her purse in it, about 25 feet away, so she could come capitalize on her chance encounter with your's truly. She even whips out a signature pad, asks me to sign, and says she'll be happy to get me some Flatulata samples out of her trunk.

I frantically looked around for a cop, or someone having a stroke I could run to help, or a judge who could issue me a restraining order on the spot. No such luck. Just a lot of people staring at me and Rikki.

So I said "can you hold this for me?" and handed her the tomato. She automatically reached for it. And I ran out of the store.

Mrs. Grumpy isn't happy about the lack of tomatoes for her arcane purposes. But I consider that the lesser of the two evils.

Dumb and Dumber

I have a nice young lady in my practice who, as far as I can tell, has only made one major mistake in life. She fell in love with, married, and had kids with Mr. Dumb. He later decided he'd rather be a crackhead, and dumped his family in favor of the excitement of living on the street and smoking crack.

So Miss Nicelady heroically soldiers on, dealing with single Mom stuff. She was awarded child support from Mr. Dumb. Unfortunately, this only gets withheld from his paycheck on the rare occasion he's actually working. So it amounts to $20-$30 once every few months, when he finds temporary work as a dishwasher.

So at her appointment today I asked her how things were going. She paused, and then began laughing.

2 months ago she suddenly began getting steady money from his child support withholding- $100 or so every 2 weeks. She was thrilled, and didn't want to look a gift horse in the mouth.

Until one night, some guy she'd never heard of called to see why she was stealing HIS money!

And so the story played out. Get this, Grumpyites:

Mr. Dumb, trying to get crack money, sold his identity (Social Security Card, Driver's License, etc) to Mr. Dumber for $50.

Mr. Dumber, now hiding under Mr. Dumb's ID, went off and got a job.

And so, when Mr. Dumber began getting paychecks, his salary was withheld and sent to my patient!

Basically, Mr. Dumber paid $50 in order to have $200 a month withheld from his paychecks. How inconsiderate of Mr. Dumb not to have mentioned these minor details to his purchaser.

In addition, Mr. Dumber was also angry at my patient (like it's her fault) because he got pulled over one day, and discovered Mr. Dumb's license was suspended 2 years ago.

Miss Nicelady told me the best part of the whole thing was when Mr. Dumber told her he was going to call the police on her.

Great Job Titles

Alright folks, I'm seeing a Workers Comp case here. Her documents from the state list her occupation as a "data and document extractor".

This is a job I've never heard of, so I asked her what she does. And she said:

"I work in the mail room. My job is to open up all the envelopes, and give the letters to the sorting people."

So that's what a "data and document extractor" does. Now you know.

It's 3:28 a.m. Do You Know Where Your Neurologist Is?

He's at the 24-hour Wall-to-Wall-Mart, buying a boatload of decongestants for the stuffy nose that's kept him up all night.

And the cashier is a girl with a shaved head, different colored eyes, and a surgically forked tongue.

She's wearing a T-shirt that says "Eat Corpses Now!"

Attached to the T-shirt is a big blue Wall-to-Wall-Mart "How can I help you?" button.

He has an Appointment in..... the Twilight Zone

A guy comes in today, signs in, and sits down in the waiting room. Mary, my secretary, checks the sheet and comes back to me. He doesn't have an appointment today. How do I want her to handle this?

So she starts talking to him. He insists he has an appointment today, and to prove it he pulls out an appointment card. On a crumpled card, in Mary's handwriting, it says "Next appointment: May 27, 2008"

So Mary checks the schedule. Sure enough, he had an appointment on that day. Which, of course, he no-showed. And hasn't been here since.

So we tell him he's a year late for his appointment (which is a record for my practice), and offer to reschedule him (we're swamped today).

So what does he do? He gets pissed off (in front of my full waiting room) that we won't see him today.

Nice Shirt

My 10:00 today is wearing a T-shirt that says "If It Weren't for the Gutter, My Mind Would be Homeless".

That's great.

That's Just Stupid

I was in the doghouse because Mrs. Grumpy asked me to hit an ATM while I was out over the weekend, and I forgot. It slipped my mind today, too, but she e-mailed me since she knows I'm a ditz.

So I pulled into a drive-thru ATM on the way home. New machine type, never seen it before. While I was doing my transaction it kept whistling and beeping at me.

While removing enough Grumpy cash to keep me from being banished to the couch, I noticed this sign over the cash-slot.

"This machine has been equipped to provide audio cues for our visually impaired customers".

If you are too "visually impaired" to operate an ATM without assistance, than WHAT THE F--K ARE YOU DOING DRIVING A CAR!!!

It was a 3 Day Weekend, Wadda Ya Want?

I'm listening to iTunes on my computer. It's randomly picking songs while I review charts on today's victims (uh, I mean patients).

It's been 20 years, maybe more, since I last saw the Rocky Horror Picture Show (yes, folks, in my younger days I was a Feature Creature). Anyway, at some point the computer picked the movie soundtrack, and began playing it.

And it dug up my old memories. So, without thinking, I began yelling out the old responses, just like I did at the movie.

I didn't even realize what I was doing until I looked up to see my staff were all standing in my office doorway, trying to figure out if they should call a neurologist, or psychiatrist, or Dr. Kevorkian.

Leave me alone. It was a 3 day weekend, and I need another Diet Coke.

Thank You, Whoever You Are (If You Know)

I'm drinking my breakfast Diet Coke and staring at the screen, wondering if I should make an entry for today. Or, in honor of Memorial day, should I just re-run my VFW post?

Of course, never fear, my patients won't let me down. My cell phone rings, and someone out there just left this voice mail:

"Dr Grumpy! I need your help! Someone's been wearing my socks and stretching them out! Please call me!"

And of course, no name or phone number was left.

Nine Minutes After Midnight

My cell phone rings at 12:09 a.m. on this Sunday morning, waking me from a dead sleep. I recognize the caller ID number, which is a bad sign already. It's Mr. Bozohusband. He and his wife are notorious for pointless phone calls.

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

Mr. Bozohusband: "Hi, I have a question about my wife's medications."

Dr. Grumpy: "What's up?"

Mr. Bozohusband: "She had dental surgery 2 days ago, and the dentist gave her Vicodin. Is it safe for her to take?"

Dr. Grumpy: "Hasn't she taken Vicodin for years for her back pain? She's never had any problems with it before."

Mr. Bozohusband: "No, she hasn't. But this is for her dental surgery, not her back pain."

Family Fun

Part of taking a patient's story down is getting a family history. This is often skipped by docs in a hurry, but can be quite helpful in looking for the odd genetic disorder. So I still try to do it on each new patient.

Sometimes, though, you can get some mighty weird answers. So, to help you enjoy the 3 day weekend, here are a few from my archives.

"My mom had diabetes, but only when she was alive."

"Both my grandmothers got menopause. My mom may have it, too."

Dr Grumpy: "Any major illnesses in your family?"
Mr. Bozo: "No, but my Dad was a Lieutenant".

"My mom died of liver cirrhosis. Nobody knows how she got it, because she never smoked a day in her life."

"My brother has diabetes. I think it's gestational diabetes."

"My mom is 80 and healthy as a horse, except for her lung cancer."

"My grandparents were from Norway, or maybe Germany, or it could have been England. You know, one of those Russian countries."

"My parents are both fine, but my goldfish has been sick."

"My father died of uterine cancer".

"Family illnesses? Hell, Doc, I don't even know my Mom's last name anymore. She changes it all the fucking time".

Nice to Meet You, Mom

My 11:00 was a migraine patient who refuses to take medications, or Botox, or do anything else I have to offer for her migraines. Fine, that's her decision.

Yet, she keeps coming back to me to complain about them!

So today she brought her mother to the appointment. After reviewing (yet again) all the commonly used migraine treatments, the patient again refused them.

So then Mom starts yelling at me! "You are incompetent! You are a fool! You should be able to fix my beautiful daughter's migraines! I see her suffering every day!"

When I pointed out that I'd offered several treatments for migraines, and her daughter had refused all of them, she got even angrier! "That has nothing to do with why she is suffering! You are trying to change the subject!"

Then they both got up and walked out. Mom said she's going to take beautiful daughter to see "a real doctor!".