More Phone Calls

My office is closed today for the holiday, so my message says "Hi, my office is closed today for the Independence Day Holiday."

It's amazing how many people who call in feel this is something they need to leave a pointless message about (without a name or phone number, of course). So far today I've gotten:

"Oh, I forgot it was a holiday this weekend."

"I guess you're closed today."

"My regular doctor is closed, too".

"It's hot today"

"What time today will you be opening?"

"Since you're closed I'll call back next week."

"Are you completely closed? Or are you seeing patients today?"

Say That Again?

Working my way through some data research surveys about up-and-coming products. What do you guys think of this quote from one:

"Product M is not statistically non-inferior to Oxycodone in both relief and non-relief of pain".

An AWESOME Drug Rep

Oh, this was just a TERRIFIC way to end the work day. I couldn't have asked for something better.

Mrs. Grumpy had a meeting tonight, so I had to feed the kids. Fortunately for me, a Big Pharma, Inc. drug rep brought lunch today to the office, and there were a lot of leftovers.

So as I was leaving this afternoon I grabbed a big bag out of the cabinet (with the Big Pharma, Inc. logo on it), tossed the leftovers into it, and headed out.

As I was passing a cardiologist's office on my way to the elevator, a pretty female rep I'd never seen before, wearing a Big Pharma, Inc. name tag, came out of his office. We made eye contact, and I nodded, smiled, and continued on my way.

Only to be stopped after another few steps by her saying loudly, "Oh MY GOD! What are you doing?"

I turned around to find Ms. Prettyrep looking at me, horrified, with her jaw agape. "Excuse me?" I said.

Ms. Prettyrep: "Are you taking food from a doctor's office?"

Dr. Grumpy: "Um, yeah, is that okay?"

Ms. Prettyrep: "NO! It's rude! It's unacceptable and inappropriate! And look at the way you're dressed!" (I tend to be on the casual side) "No name tag!. What are the corporate people teaching you new reps, anyway?"

Before I could answer she went on: "I'm sorry. I suppose this isn't your fault. The training people must be slacking off." She offered me her hand. "You must be new. I'm Stacey, from our cardiology marketing division here".

I shook her hand. "I'm Dr. Grumpy, from the neurology division down the hall."

Stacey from the cardiology marketing division looked even more horrified now then she had a minute ago. After a few stuttering attempts at saying something she answered her cell phone (which hadn't rung), mumbled "nice to meet you" and ran into the stairwell.

Tips for Patients

When asked "What brings you to see me?" the following answers are NOT acceptable, helpful, or desired:

1: "A car" (or bike, bus, or other method of transportation).

2: "My PCP said I should see you."

3: "My daughter drove me."

4. "The hospital sent me."

5. "My medical problems"

6. "The guy at the grocery store told me I should see a neurologist"

7. "Your name is on the referral".

8. "What kind of doctor are you?"

9: "I need a refill on the white pills with numbers on them"

10. "You were on my insurance plan."

Still Fuming at the FDA!

It should be noted that more people visit an ER and/or die, as a result of mishaps with cars, OR swimming pools, OR alcohol, OR tobacco, THEN AS A RESULT OF TAKING PERCOCET, VICODIN, OR OTHER TYLENOL CONTAINING PRODUCTS!!!

SO HOW COME YOU GUYS DON'T ALSO BAN CARS, SWIMMING POOLS, ALCOHOL, AND TOBACCO WHILE YOU'RE AT IT?!!!!!!!

Attention FDA!

Vicodin and Percocet don't kill patients!

It's the big pillow I want to smother them with when they ask for more Vicodin and Percocet that could kill them!

Neurotics at Law, P.C.

I had a deposition in my office yesterday. One of the lawyers showed up a few minutes late, set his briefcase down in the hallway, and we got started.

But after a few minutes he started squirming in his chair, like a little kid who had to pee. He looked very jittery and uncomfortable. So I told the court reporter to stop recording, and asked Mr. Attorney "Are you okay? Do you need some water, or to use a restroom?"

He said: "No, but I really need to get something out of my briefcase". Me and the other lawyer said fine, so he went out to his briefcase and opened it.

He came back in a few seconds holding a large rubber band. He sat back down and began playing with it, twisting it back and forth between his fingers. After that he was fine and calm for the rest of the meeting.

We Have a Winner!

My secretary Mary saved this awesome message that came in over lunch hour.

Slurred voice: "I need to make an appointment to see Dr. Grumpy. I take lots of pain medications, because I'm in constant pain, sometimes. But I'm not taking any right now, because my pain is so bad that I can't take my medicines. I've run out now, but still have plenty, but think I might need more."

I told Mary that if they call back to tell them I don't take their insurance. Even if it's cash.

Does Anyone Else Think This is Weird?

All right, this is an actual e-mail Mrs. Grumpy got from her Mom today about a new set of pots & pans my in-laws bought. I think it's weird, but maybe it's just me.

"Okay, we went to a Salad Master sales dinner and bought us some top-of-the-line cookware.

We didn't get the big set, which has enough pans to cook for an army. We bought a starter set and got 3 extra pieces just for foolishly buying this over-priced cookware. It is very nice, and I know I will like it.

It comes with a 'beyond your lifetime warranty', meaning it's guaranteed to outlast us. So we had to list you as a next of kin for who the set and warranty will transfer to when we die.

So your name is listed as an owner also...so when we no longer need, or can use the cookware...behold, you are the proud owner, and are already registered with the company as the future owner."

MJ Follow-Up

Thank you all for your comments on Michael Jackson's death impacting my patients.

To briefly touch on my only other professional encounter of this insane sort, in 1997 I was taking call for an Epilepsy Monitoring Unit. The night nurse was named Sue and, while a good nurse, she was unusual to say the least.

Anyway, one night I'd dozed off at home in bed, and was woken by Sue.

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

Sue: "This is Sue, in the EMU. She's dead."

Dr. Grumpy: "Oh my God! Who? Mrs. McFadden in room 3?"

Sue: "No. Princess Diana."

Dr. Grumpy (still a bit drowsy): "Is that the lady in room 4? I thought she went home yesterday."

Sue: "No, Princess Diana, ya know, the British royal family and all. She died in a car crash."

Dr. Grumpy: "You paged me at nearly midnight to tell me this?"

Sue: "I think it's important."

Dr. Grumpy: "Are the patients okay?"

Sue: "Yes, I haven't told them yet."

Dr. Grumpy: "Please don't and let them sleep. Good night, Sue."

Espanol para Nurses

Last night, while I was on rounds, the staff was looking at a book of medical Spanish. In a section of phrases that nurses should know it included translations for:

"You can smoke in your room."

and

"Please don't hang from the ceiling."


How useful is that? And not a single phrase for "don't pull out your IV" or "You're in a hospital, not a Hilton".

How About "My Dog Ate My Reminder Card?"

Okay, I just want my patients to know that there are some good excuses to cancel your appointments at the last minute. AND MICHAEL JACKSON'S DEATH IS NOT ONE OF THEM!!!

So far today I've had 1 person cancel because she's too depressed over his death to make her appointment today, another who said he can't come in because he's too busy watching continuous coverage on E! about it. And a third who (somewhat vaguely) canceled "because of the world situation".

You people need a life.

Hazards of Multitasking with Age

Mary, my wonderful secretary, had to run out early today for her kid's little league game. In the chaos of trying to shut everything down, she forgot to roll the phones over.

I don't have an answering service. I just roll the calls over to my cell phone. I don't find this a problem, though I know other docs are horrified at the idea.

Anyway, while I was frantically trying to finish dictations, I rolled the phones over myself, then dialed back in to make sure it was working.

Then my cell phone rang, and I immediately grabbed it, saw the number looked vaguely familiar, and answered my own call.

I'm so glad Mary wasn't here to see this. She'd be giving me crap about it for weeks.

It's the End, the End of the 70's

(for those of you who recognize the title, congratulations!)

WARNING: THE FOLLOWING POST IS NOT FOR THE SQUEAMISH. I MEAN, IT'S NOT AS BAD AS THIS STORY FROM MY ESTEEMED COLLEAGUE ERP, BUT IT AIN'T GOOD EITHER. SO STOP READING NOW IF YOU THINK IT'S GOING TO FREAK YOU OUT, OR IF YOU'RE EATING.

Before Viagra and it's cousins, there were some other methods of waking Sheriff Woody. They're still out there, for those who have issues with Viagra.

One of them is Caverject (or Alprostadil for my pharmacy fans). This is fairly effective at getting it up for special occasions. They have to be pretty special, though, because Caverject has to be injected directly into the side of your winkie for it to work. What fun.

Because it came to market before the era of direct-to-consumer celebrity advertising, we were fortunately spared TV ads featuring Eric Clapton singing (to the tune of "Cocaine"):

"If your lady is hot
Just give yourself a shot-
Caverject."

But I digress.

I have a patient who's been using Caverject for years. For whatever reason he can't use one of the newer drugs. He's kind of an aging, swinging, disco guy. In the 70's he was swinging, single, wearing gold chains, and picking up babes at the disco. In 2009 he's still swinging, still single, still wearing chains, and now picking up aging babes at the disco.

A few weeks ago he had a small stroke (he's fine now), and as a result he's now on Coumadin, a potent blood thinner. This gives new meaning to "Stayin' Alive".

So last Saturday he was out getting his boogie on and picked up Ms. Agingdiscoqueen. They went back to his place for some wild times. He shot himself up with Caverject and the fun began.

And abruptly ended. Apparently she got on top, and while she was riding the disco pony, blood began squirting out the side where he injected Caverject (thanks to Coumadin). Seeing blood flying all over those dark areas killed the mood fast. She ran out, and likely went home to douche with bleach.

He's been visiting me and his cardiologist today, to discuss stopping Coumadin.

Thus endeth the 70's.