Happy Friday

Driving home at the end of the work week, and my cell phone chimes. Someone left this message:

"Hi, I'm calling for Dr. Grumpy. I'm not a patient of yours, but I found your name on my insurance list. Can someone please call me back before dinner? I need to know if sandwiches left in my car for 15 minutes can still be eaten. Thank you."

Anatomy 101

Reviewing some records on one of today's patients. I found this note from another doctor:

"His numbness is in the right arm, covering the area from the thigh to the knee."

My Readers Write

Wick, one of my readers, was kind enough to send in a story for a prescription recently handled at his pharmacy.

It was for the Nuva ring, (a rubbery ring with birth control hormones, that's placed intravaginally once a month).

The script was written for Nuva Ring, 1 po qD (that means 1 ring taken BY MOUTH each day).

What's scarier is that when Wick called the GYN's office to clarify this, the "nurse" there (could also be an MA or secretary for all I know) argued with him about how the Nuva ring should be used.

I can picture this happening:

Jenny: "Hey Suzy! What are you chewing?"

Suzy: "It's my new birth control gum!"

Jenny: "Wow! I had no idea there was such a thing!"

Suzy: "Yeah. It's kind of rubbery, and you wouldn't believe what the pharmacy idiot told me I was supposed to do with it! Good thing I called to ask my doctor's office what the right way to use it is!"

Death to Junkies!

I hate my junkies. I don't have many. Every doc has at least a few, and you just learn to deal with them. Some you created by accident (though your original intentions were good) and some you inherited from some other neurologist who had the audacity to die, retire, or move.

What drives me nuts, though, are the ones who come in that way, and try to play you from the word go. And today I had one.

He came in, and after listening to his pathetic story (complete with violin music) I ordered an MRI. He said he was claustrophobic, so I gave him a script for 2 Valium tablets.

After the appointment he walked out to the check-out desk, which is roughly 20 feet from my office. He then told my secretary that he'd lost the Valium script while walking up front, and could she write him a new one (last I checked, my staff ain't allowed to issue scripts for controlled substances).

So she said she'd go look for it, whereupon he suddenly "discovered" it was in his shirt pocket the whole time. Bozo. So he went on his way.

Within an hour Local Pharmacy had called me to query the script. The one that he brought to them was for 200 Valium tablets, not the 2 I'd written for. And was altered in a different ink color.

Sorry, dude. Game over. Go play with someone else.

I Don't Remember Who's Forgetting

Dr. Unka is in my office complex. When he refers a patient to me, he often walks them upstairs to my office and waits with them up front (while his own waiting room backs up) until Mary has scheduled the patient. He often asks that I drop everything I'm doing to come meet his new referral, instead of just having them call us to make an appointment.

So today Mary called me to say Dr. Unka was up front, and wanted me to come meet a new patient. So I excused myself from my current patient and went up front, to see him standing there with a familiar, somewhat irritated-looking, older lady.

Dr. Unka: "Ibee, I'd like you to meet Mrs. Ancient. I'm referring her for memory loss."

Dr. Grumpy: "Uh, I saw Mrs. Ancient 3 weeks ago for that."

Mrs. Ancient (glaring at Dr. Unka): "I told you! Why didn't you listen to me?"

Dr. Unka: "She did?"

Mrs. Ancient: "Yes!"

Dr. Grumpy: "Yes, I sent you a note."

Dr. Unka: "You did?"

Mrs. Ancient: "Yes! He did! It was even in my chart at your office! I pointed it out to you!"

Dr. Unka: "You did? Um, I mean, then have her make a follow-up." (leaves my office).

So in this situation, who REALLY needs to be seeing the neurologist?

Thanks. That Didn't Help AT ALL!!!

I had a hospital consult called in last night on a confused lady. So I stopped by to see her this morning.

Since the patient is confused, I do my usual assessment for orientation, memory, etc. When I walked into the room her nurse followed me. She was a new hire I'd never seen before.

So I went in, introduced myself to the patient, and started: "Mrs. Jones, do you know where you are right now?"

Before Mrs. Jones could answer Nurse Dingbat, with a look of astonishment, said "We are in the hospital, Doctor."

Today's Schedule

My secretary Mary types on the fly as she's talking to people on the phone and putting their info into the schedule. So occasionally something odd shows up. This is on today's schedule:


"9:00- Mike Smith. BCBS. Coming in because he works at the liquor store across the street."

Tacos for 99 cents, IQ of Far Less

We like a local place's fish tacos, and Tuesdays are 99 cent fish taco days. So after picking up the kids at camp, I stopped to get a bunch (is school the plural for fish tacos?) for dinner.

My kids noticed a large fish tank inside and went to check it out. Frank yelled "Look Dad! A fish tank"

I said, "that's where they get the fish tacos from". Frank laughed and told me I was silly, while I went to order

The bozo at the cash register looked at me and said "Actually, sir, all our fish is from the ocean and delivered here. The ones in the aquarium are just for decoration".

Stupidity and Reproduction

Another fun morning at Grumpy Neurology, P.C.


Mrs. Dimbulb: "My husband and I want to have kids. How do my migraine pills affect that?"

Dr. Grumpy: "What sort of birth control are you using now?"

Mrs. Dimbulb: "What's birth control?"

Reasons Your Doctor is Prematurely Bald

The hospital I work out of has been transitioning over to an electronic chart system.

This morning, while back on rounds, I dialed in to the hospital system to dictate a consult. I was stunned to be told that my priviliges had been suspended while I was gone for delinquent medical records.

This was a shock, as I treat medical records with an obsession. Every Thursday I stop by medical records and ask if there's anything for me to sign. For the last 6 weeks the girl there has politely checked her computer, then said "Nope, thank you for checking".

So I promptly marched down there:

Dr. Grumpy: "Excuse me, do I have anything to sign today?"

Ms. Helpful: (looking at her computer) "Um, nope. Thank you for checking."

Dr. Grumpy: "Well, when I dialed in, it says I've been suspended for medical records delinquency."

Ms. Helpful: "That's correct. You have over 60 charts to complete, 28 of which are delinquent"

Dr. Grumpy: "WHAT!!! Then why didn't you tell me that?!!"

Ms. Helpful: "You only asked me if you had anything to sign. You have nothing to sign. We are all electronic records now. You don't actually sign anything."

Dr. Grumpy (in shock): "Okay... So how do I complete my records?"

Ms. Helpful: "You have to log into the e-Chart system."

Dr. Grumpy: "No one told me we'd completely switched to e-Charts, or that I had records to complete. How was I supposed to know this?"

Ms. Helpful: "Because the first time you sign in to e-Charts it tells you that".


No wonder my hairs are jumping off like lemmings.

Back to the Salt Mines

On the way home, and reviewing calls from the last 2 weeks that my nurse Annie had marked as "Extremely Non-Urgent". They include:

"Can I get a prescription so my insurance will pay for a Roomba? I'm too tired to vacuum anymore."

"Can a Wii cause Alzheimer's disease? Cause my Dad had played it with my kids the night before his appointment. Can I sue someone over this?"

"Does Dr. Grumpy recommend any particular grade schools in my area of town?" (WTF do people call with questions like this? Do I look like the Shell Answer Man?)

"Which of the summer movies is least likely to worsen my migraines?"

And, inevitably: "I haven't seen Dr. Grumpy since 2003, but can you guys call in some more Vicodin for me?"


And the insanity of my office begins again.

Grumpy Summer Vacation, Day 11

We were in Ensenada today, which was an alternate stop due to the hurricane earlier in the week. In my experience, the best part of docking here is not getting off the ship.

My first time here was when I was single in 1993. A girl I’d met and I decided to try the "Scenic Gold Coast" bus tour. It turned out to be a drive through one of the ugliest areas I've ever seen. I kept hoping we'd come to the scenic part soon, but the bus just stopped at a “deluxe resort” (which was a dump), we each got a glass of shitty watery beer, and then got driven back.

In 2003 Mrs. Grumpy didn't believe me and insisted on going on the same tour, and hasn't questioned my judgment since (about that, anyway).

For you guys considering it, this is the "olympic swimming pool" at the “deluxe resort” that the bus stops at, where they give you a thimbleful of crappy beer and try to sell you timeshares. And you've paid $50 per person for the pleasure. This is not a joke.




It’s a funny thing about Mexico. This is an amazing country. Oil and other natural resources. Phenomenal beaches. Rain forests. A remarkable cultural history. A geographically excellent position. And because of irreparable corruption it remains a third world country. If they could cut corruption and develop a Japanese-like work ethic, Mexico would be a world power rivaling any other.

Mrs. Grumpy and I were in line to get breakfast today, and the omelette cook asked her if we'd be going ashore. She said, “No, I've been to Ensenada once, and that was enough”. He said, “So go back today to make it 3 times”.

Good thing this guy isn’t an accountant.

Today is the last day of the cruise. There are a handful of ways you are reminded of this. The disembarkation talk. The elevator sign having been gradually changed each day from "Maximum: 3000 lbs. or 18 people" on day 1 to "Maximum: 3000 lbs or 8 people” today.

I feel SO fat and bloated. I think I gained 40 pounds. Everywhere you walk on board someone is setting up a new counter of incredible looking food, and you decide you just want a taste. I think I ate 50,000 calories of “tastes” per day. I can barely reach my shoes to tie them.

And, as I noted before, you see lovelorn teenagers walking around, looking for any quiet area to make out. So you occasionally have an elevator door open to find them frantically untangling themselves, or sit down at a table and accidentally step on a pair under it.

The gift shop always has these "last day specials", which they push as if the ship is being scrapped in the morning. They’re somewhat comical, considering that tomorrow the ship will be taking on 3000 new suckers, uh, shoppers, just dying to buy overpriced T-shirts and stuffed animals. Mrs. Grumpy briefly glanced at a canvas beach bag, and immediately an employee came over to try and sell it. She was awesome. "This very good deal, ma'am. Regular price $29.95! But today, just for today, is marked down to $24.95! That half-off!!!"

Good thing this girl isn’t an accountant, either.

After another round of minigolf (with Marie hitting a pair of teenagers making out on a bench 2 decks below) I took her to the bar for some Diet Cokes. We arrived in time to hear 2 mechanics and a bartender arguing about a broken refrigerator. It was great, especially when the bartender said "all the refrigerators on this ship are absolute shit!" I hope the engines and watertight features are better.

The last night has brought the cruise to an appropriate end. Craig is sleeping in the bunk directly above me, and as I was typing he suddenly uttered some of the most dreaded words in parenting: "Dad, I think I'm going to..." followed by a waterfall of partially digested Cruiseship Lines foodstuffs. In the confines of our cabin it brought back college memories I'd tried to forget.

I'm glad we're going home. They may have to scrap the ship to get the smell out of our cabin.

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

Talent Show Update

We went to the Camp Cruiseship talent show to watch Marie dance. I’d post the video, but due to poor lighting it looks like a pair of white socks convulsing to “Who Let the Dogs Out?”.

Craig had signed up to do the Can-Can (Really!), but got stage fright. Frank told jokes with his face completely covered by the piece of paper he’d written them on. For the record, these were their ideas, we didn't even suggest they sign-up.

I have to say that what Marie lacks in talent she makes up for in enthusiasm. This is a family trait. In medical school my class once went to a karaoke bar at the end of test week, and (after several drinks) I got up on stage and sang a passionate rendition of “My Way”. Afterwards my roommate said “Dude, you can’t carry a tune worth shit. But boy, can you SING!”

Unfortunately, Marie was somehow under the impression she might win money for her routine (it’s a show, not a contest), and was quite disappointed to find out she didn’t. So on returning to her seat she loudly asked “Mommy, someday can you take me where I can dance for money?”

Gee, why are all the other parents staring at us?

I Don't Know This Lady

To my horror, Mrs. Grumpy (inebriated on Diet Coke) decided to participate in the ship’s ice cream speed-eating contest. This involved eating 2 scoops without your hands, placing the empty inverted ice-cream bowl on her head, and yelling "Iggy wiggy, I'm a piggy!" before anyone else.

And she blew the rest of the field away, winning big time.

She won a plastic trophy.