It's a WORD, Okay People?

(Please note, the following post is NOT meant to convey any viewpoint about abortion. Any comments trying to fight-out or inflame pro-life vs. pro-choice opinions will not be published).

I use the word "abort" in my dictations: "Her migraines are aborted by Imitrex" or "He was seen in ER, where the seizure was aborted by Ativan" or "The MRI was aborted due to his claustrophobia".

At least twice a year, most recently yesterday, I get an angry letter or phone call from some patient who is reading my notes on them and becomes incensed over this. They see the word and automatically assume it means they HAD an abortion (No, sir, that is biologically impossible") or that my use of the word is expressing a political viewpoint ("I'm devoutly pro-life! How dare you use that word in a note about me!").

Usually I just explain to them what it means, and send them to a dictionary. It's amazing how many people are stunned to find out it has some other meaning then THAT ONE, and are fine once they realize this.

In spite of this, in the last 10 years I've had 3 patients change neurologists over this issue. Whatever.

Part of being a doctor is respecting your cultural, religious, and political beliefs. That's why I never discuss mine. Words in my notes are just that. Words.

My 11:00

Hot pink shirt, electric green shorts, bright red shoes, orange purse, purple umbrella, who the fuck dressed this woman?

It's a Guy Thing

I was at the hospital early this morning to see a 70-something gentleman who had a stroke yesterday. He told me this great story, which I'm repeating (to the best of my memory) verbatim. Because I can't write them better than this:


"I drove over to Local Grocery, because my wife had been nagging me all damn day that we needed bread and celery.

"Anyway, Doc, when I got there and tried to get out of my car I found I couldn't move my left arm or leg at all. They were completely paralyzed. So by turning I was able to use my right arm to pull a shopping cart over, and then I used that to support me to get into the store.

"At first I thought I should get help or something, but when I got inside I saw they had those motorized electric shopping cart scooter deals, so I got into one and was able to work it okay with my right hand, though I knocked over a display or two. And all these damn store employees kept asking me if I was okay, like it's any of their damn business.

"Anyway, so I got the bread and celery, and got out to my car, and drove here to the ER. That was a bitch, because my cars a manual, so I had to work the clutch and brake both with my right foot, and that ain't as easy as you probably think it is.

"Then, after I got here, I called my wife and had to wait outside in your parking lot for her to come pick up her damn bread and celery. Then I came inside to the ER."

Blinded By the Light

While I was at work today, Mrs. Grumpy decided to replace the 60W light bulbs (some had burned out) over our bathroom vanity with fluorescent 60W equivalent bulbs.

I walked in there tonight and flipped on the lights.

Holy crap! The new bulbs are beyond bright. Like the light from the top of the Luxor Hotel has been moved into my john. I felt like I was peeing inside a tanning bed. I was frantically looking for Coppertone in the cabinet over the toilet.

While washing my hands I realized that the worst part of this incredible luminescence is the way it shows how many gray hairs I have (of the few left at all). I went out to complain to Mrs. Grumpy, who said she didn't care.

She went in there an hour later, and after seeing her own gray hairs illuminated so clearly, immediately drove back to Home Depot to get significantly lower wattage bulbs.

It's Midnight

Look, lady, I can, in some vague way, understand how you forgot to call for a refill on your seizure medication until you were all out. We all screw up here and there.

And I can even understand you frantically calling me at midnight to get a refill. I guess I'd rather have you do this then get called at midnight by an ER doc because you seized and wrecked a car and hurt somebody.

HOWEVER, I DO NOT have your chart in front of me at midnight. When you wake me up I'm lucky to remember my own name. So telling me you need your refill at "the same pharmacy as last time" doesn't help. Neither does your insistence that "I think it's a Walgreen's, you know, one on the west side". We live in a big city here. There are Walgreen's on every other street corner.

And when you finally find a phone number, don't ask me if it's a 24 hour store, or where the nearest 24 hour place is, or what your co-pay is. I just call in the scripts. I am not the Shell Answer Man.

What Sort of Doc Do You Think I Am?

Lady, the long plastic thing hanging by my exam table is a freakin' shoehorn. It's 2 feet long to help my Parkinson's patients use it without having to lean too far over.

IT IS NOT SOME SORT OF VAGINAL SPECULUM.

And no, I ain't gonna do that, either, to help save you a co-pay. I do what I do for a reason, in case you missed Monday's post on it.

You want that kind of exam, call ER's Mom.

Beggars as Choosers

You people are in the damn Medicare donut hole, and I understand that. You call my office looking for free samples, and I try to help. Your internist has a "no samples" policy, but I try to be nice and help you guys save some dollars when you are in the Medicare donut hole, because I know how damn expensive your pills are, and I am trying to help. That's why I became a doctor.

I called my drug rep, and he was actually quite nice, and dropped off a case of your damn pills. It was easy, because his company accidentally sent him a case of samples labeled in Spanish that was meant for a neighborhood across town. So he was happy to contribute it to your care, instead of having to fill out the paperwork to send it back to his company.

They are the same damn pills. You can see them through the plastic. The same pill name and pictures are on the same damn box. You can see that for yourself.

I am trying to help you. So don't stand in my damn lobby and yell at me and Mary because you don't want "pills for Mexicans". You want free pills? Here they are. I wrote the instructions out in English, for crying out loud.

You are the losers who stomped out because I didn't have pills with English packaging, and now you're calling back. Sorry, but now that you've gone home and realized how much it costs to buy the same pills, it's too late to have a change of heart. I'm going to give them to a decent, non-bigoted person. And don't whine to me about how you may not have enough money to buy them. You had your chance at a damn month of free pills, and stomped out with attitude.

What a Drag!

This is too good not to post.

A criminal gang of cross-dressing gay bar performers, who stole over $30,000 in dresses and other feminine things to wear in their shows!

Check it out!

Catch-22, HMO Style

Reading the faxes from overnight.

Idiotic HMO, Inc., sent over a note saying that they were refusing to pay for a patient's MRI because "This does not meet our criteria for lumbar spine MRI's. The patient must undergo a minimum of 8 weeks of physical therapy, without benefit, before an MRI will be authorized."

Farther down on the same page, under guidelines for physical therapy, it says "Idiotic HMO, Inc., will not cover more then 6 weeks of physical therapy per calender year."

No, Not THAT Bible

We all have a book that is our "Bible". After an insane day like yesterday, I go home and read mine (and no, I don't read it in the john).

So what is Dr. Grumpy's bible? Some neurological work by Charcot? A medicine tome by Osler? Nope.

My staff has learned that when I refer to "The Bible" I mean a small book (I've given them all copies) called "Kill as Few Patients as Possible" by Oscar London, M.D. It's a remarkable collection of 57 essays on "how to be the world's greatest doctor". It's a scream. I first read it in 1992 in medical school, and it's since been kept at arm's reach. Any aspiring physician (or anyone who needs a good laugh) should get it.

(Disclosure- I do not know who Dr. London is, I am not selling copies of this, and I have no financial interest in any booksellers whatsoever).

So, Dr. London, if you are reading this, I just want you to know that I think you are awesome. And I continue to try to practice by your rules.

What a Day

The afternoon ended with me ordering an MRI on a 30-something guy.

I'm filling out the MRI form, and automatically checked "No" on the question "Is patient pregnant?"

The guy leans over and says, "Hey, you need to change that."

Dr. Grumpy: "Uhhh, are you pregnant, sir?"

Mr. Bozo: "No, but my wife is. Wouldn't that also affect an MRI that I'm having?"


That's enough insanity for one day. I'm giving up and going home.

Drug Rep Fun

Okay, gang, I've just finished lunch with a drug rep. He represents a narcotic drug, so as a result he can't give me samples for patients to try. The guy is originally from Germany, and the accent, for whatever reason, always adds an extra layer of formality to these meetings.

Under these circumstances most companies give out coupons for the patients to redeem for a week or so of pills, so I asked this guy if his company would be giving us those.

He gave me this horrified look and angrily said (in his German accent) "At my company ve do not believe in prostituting our drugs!"

Okayyyyyyyyyyy.....................

More Weirdities

Today just seems to be shaping up as weirdness in the medical world.

While I'm not trying to take sides online in the animal rights vs. medical research issue, this article today caught my attention.

A group of animal rights activist in Switzerland have targeted the CEO of Novartis pharmaceuticals by (among other things) stealing his mother's ashes!

Medical Research

The West Virginia branch of our Science Marches On Department has brought the following enormously important medical research to my attention.

(click to enlarge)



FOLLOW-UP COMMENT: The Texas branch of our Science Marches on Department, upon reviewing this article, had several questions which I thought were worth printing:

"(a) Does it matter what you read? Sci-fi, romance, action-adventure, military history, self-help, etc? More work in this field is needed.

(b) Since this was done in Israel, does it make a difference if you read left-to-right or right-to-left?

(c) Is this why they call Jews the People of the Book?

(d) Do you get the impression that the Primary Investigator did this research because his wife complained about his reading on the john and gave him some old wives' tale about how it's bad for you?

(e) I know (from personal experience) that Haifa isn't the most exciting city in the world, but how bored do you have to be to come up with this?"