Weekend On Call- The Phone Calls

Dr. Grumpy: "This is Dr. Grumpy, returning your call".

Mr. Phone: "Um, yeah. I see Dr. Notoncall, and she has me on Aspirin 325mg once a day for a stroke, and, um, I was wondering if I can change it to the baby Aspirin 81mg size once a day instead?

Dr. Grumpy: "Are you having stomach problems or bruising, or another problem with it?".

Mr. Phone: "No."

Dr. Grumpy: "Then why do you want to change it? If Dr. Notoncall told you to take 325mg I assume she had a reason."

Mr. Phone: "Cuz my buddy, Phil at the paint shop, told me he thinks the 81mg is gonna be better for me. Ya see, my girlfriend bought me the bottle of 325mg after my stroke, but she and I broke up yesterday, and I'm not gonna see her again. So Phil pointed out that since she's the one who got me the 325mg size, maybe now that she's left it's not a good idea for me to be taking them, and so I should change sizes to something she didn't buy me".

(Long pause)

Dr. Grumpy: "Sir, I think you should stay on the 325mg pills. It's what Dr. Notoncall told you to take."

Mr. Phone: "Is that safe? Cuz my ex-girlfriend bought them, and Phil said..."

Dr. Grumpy (interrupting): "If it's that important to you, then you can buy your own bottle of the 325mg and get rid of the one she bought you."

Mr. Phone: "Am I allowed to do that?"

Dr. Grumpy: "Yes."

Mr. Phone: "Okay, but I'm gonna go to a different store than she did."

Mr. Jackass- The Sequel

For those of you who've already forgotten who I'm talking about, click here. It's also only been 3 days, so you should probably go see a neurologist.

So his appointment was at 10:00 today.

10:00 - No Mr. Jackass.

10:05 - No Mr. Jackass.

10:10 - No Mr. Jackass.

10:15 - Phone rings. It's Mr. Jackass's secretary. She's calling to say that he's in the lobby of my building, but is tied up in a VERY IMPORTANT telephone meeting, and can't come up right now. Mary told her that we don't see new patients who are more than 20 minutes late. She says she'll tell him.

10:17 - Mr. Jackass, cell phone glued to head, shows up. Signs in. He looks at Mary and says, "There. I'm here. Now let me finish my meeting" and sits down in the lobby. Argues with someone on the phone.

10:18 - I go to door, call him back. He doesn't even look up, just gives me the "I'm on the phone, leave me alone" gesture.

10:20 - My 11:00 (a follow-up visit) shows up early. So I take her back. Mr. Jackass gives me dirty look when I call her back, but continues his meeting.

10:35 - Mrs. Follow-Up and I finish her appointment, and I walk her out. I give Mary the "Mr. Jackass is toast" gesture, 15 minutes after I should have.

10:40 - Mr. Jackass hangs up his phone

He goes up to the front desk and tells Mary that "He'll see Dr. Grumpy now". Mary tells him that he's missed his appointment, and can no longer be seen. He starts yelling at her, saying he was here on-time, and in my office by 10:20, like we told him. Demands to talk to the office manager.

I was standing out of sight behind a shelf, because I expected this to happen and wanted to hear it. So I made my appearance. He immediately laid into me about the fact that HE WASN'T BEING SEEN ON TIME BECAUSE HE'D BEEN SITTING IN MY LOBBY FOR A WHILE AND WAS A BUSY GUY WITH STUFF TO DO.

I told him that it's our office policy that we don't see, or reschedule, new patients who are more than 20 minutes late. He insisted he wasn't late. I told him he was, and pointed out that when I tried to call him back for his appointment he'd refused to come back because he was on the phone.

So he demanded to talk to Dr. Grumpy.

And I introduced myself.

For perhaps 10 seconds it was so quiet you could have heard a pin drop.

Then he picked up his phone, pressed a key, and said "Yeah, it's me. Patch me back into the meeting". And walked out the door.

At 11:45 the ER called me. He'd gone over there and told them he needed to be evaluated for a stroke. They asked me to come over and see him. I said no.

And to all a good night.

Mr. Jackass, Part Deux

Yes, he showed up... sort of.

Gotta see patients right now (blogging isn't my day job, though I wish it was), but thought I'd at least end the guessing.

I'll post full details later tonight or tomorrow, Grumpyites!

Dear Insurance Bozo

Your patient recently had an extensive work-up (as an inpatient, no less) for her migraines. I wasn't involved in it, but it looks like she was in the hospital for 5 days, and had several MRI's, a spinal tap, and a bunch of other tests. I'm sure her bill was pretty damn high.

She came to see me yesterday for her headaches. She doesn't want any more tests, and doesn't want to go to ER, either. So it sounds like she's trying to save you guys some dough, too, at this point.

So it was really a surprise to find that you bozos refused to authorize my prescription for a CHEAP FUCKING GENERIC drug (which according to drugstore.com is priced at 11 cents a pill) to help her feel better, and stay out of the ER. Instead, you told me it was "experimental" (although it's been a standard treatment for over 20 years) and faxed me 5 pages of forms overnight to get it authorized.

You guys can eat my shorts. I prescribed a drug that's $1.25/pill, now, and you bozos actually cleared it. Way to save some money there.

Wait'll your CEO finds out how this is gonna impact his bonus this year. He won't be happy.

OMG!

Thank you, Mrs. Monday-Attwo, for faxing over some information in advance about your symptoms.

I've seen a lot of neurology, and I'm sure what you have is called a Bell's Palsy. It's a common, usually self-limited, droop on one side of your face.

There are still neurological conditions out there that I haven't heard of, but I don't think you have one of them.

I'm not sure where you're getting your information from. Maybe you didn't hear the ER doc correctly. Maybe the ER nurse was in a hurry and her handwriting on your discharge instructions was sloppy. Maybe English is your second language.

But, as far as I know, this condition that you listed on your fax doesn't exist.

It says "Bell's Pussy".

If you do indeed have such an unusual condition, I recommend you either see my esteemed GYN colleague ER's Mom, or take your cat to a vet, depending on the circumstances.

See ya Monday!

Dear Dr. Sealfon,

Congrats on being named neurology chairman at Sinai.

I have no idea why you sent me an announcement. I mean, nothing against you, but we've never met (unless it involved a drunken encounter that I've forgotten). In fact, I hadn't heard of you until I got your lovely card in today's mail. I'm sure Mount Sinai is a fine facility, but I've never been there. After 20 years, I honestly don't remember if it was one of the many medical schools that rejected me in the late 1980's.

So I'm entirely lacking in ideas as to why your institution paid to kill a tree, print a card, and mail it to me to trumpet your news. Annie thought maybe you were fishing for a gift, like those cheesy "Hey! I Graduated from High School Again" notes that the kid who delivers the paper sends. But I have no idea what to get you. A $25 U.S. Savings Bond? A Chia Pet? A "Trees for Israel"* certificate? Given that I'm not exactly down the block from you I'm unlikely to be referring you any patients (nothing personal).

Anyway, good luck in your new job. If anyone at Mount Sinai has even the slightest idea as to why I'm on your mailing list, please let me know. They can also take me off it to spare future trees from any further announcements.

Yours truly,

Ibee Grumpy, M.D.

*For those who didn't grow up with Jewish friends in the 70's-80's, the "Trees for Israel" certificate was a remarkably lame gift for equally lame occasions. It basically was a paper with your (usually misspelled) name typed/written/crayoned on it, saying that in your honor a few bucks had been given to plant trees in Israel. It often misled you to believe that somewhere in Israel there REALLY WAS a tree with a plaque and your name on it, which is a story in itself. Anyway, they made incredibly disappointing gifts ("Wow, Ibee! Mark got you a GI Joe super-charged missile-action tank set, and Joe brought you a "Trees for Israel" certificate." And Joe would be so embarrassed that his Mom got you one that he'd be hiding in a paper bag). So now you know.

Whatever

"Look! I'm not stupid! I'm not a doctor, but I know A LOT about medicine. I mean, my brother-in-law's cousin is married to an optometrist!"

(No offense to optometrists is intended).

I Love You People

Mr. Jackass, I'm sorry we couldn't accommodate your busy schedule to work you in today.

I understand you're frustrated. I mean, I would be too if I'd been walking around since yesterday with slurred speech and mild arm weakness. It's a real pisser that you're having trouble texting your real estate clients with your thumb being clumsy like that.

Yeah, I can guess you had a stroke. I'm a neurologist, and I didn't need you to tell me that. I agree that under most circumstances this would be urgent, but my day is full, and having you walk in and start yelling obscenities at Mary because she told you we were booked solid today doesn't increase your sympathy rating around here.

I'm also sorry you were unable to take the appointment she did offer you, tomorrow morning at 8, because you have a meeting with a homeowner's association. I know those things are important. And you have that finance meeting on Thursday at 1, so you couldn't come in then, either. So I guess I'm seeing you on Friday at 3. I know you told Mary that was unreasonably long to have to wait for a stroke, and I'm sorry. Because of my casual dress habits you obviously didn't guess that the doctor was the guy standing in the lobby next to you, because I'd gone up to refill my water bottle.

Mary suggested, several times, that you go to ER, and I was standing there when you refused because you didn't have time for "that sort of nonsense". I told you to go to ER, too, but when you said "who asked you, Buttinski?" I decided to let you keep thinking I was another patient or a drug rep or something. Mary should get a raise for keeping a straight face.

I bet it would surprise you to know that while you were arguing with Mary I walked back to my office to log into the hospital system to see if you'd been there, and, SURPRISE there you were! It looks like you actually went in yesterday, after you'd finished cleaning your pool, and left AMA. The ER doc clearly documented that he wanted to admit you for an inpatient work-up, and you told him he was being unreasonable because then you'd miss the Labor Day barbecue you'd spent all week preparing for. I hope you didn't burn too many burgers with the bad hand.

I'll see you on Friday. Bet you'll be surprised to see what I'm wearing.

Pancake Time

Mr. Syrup, I have absolutely NO IDEA WHATSOEVER if the IHOP* down the street is a "participating restaurant" in the coupon deal that you have folded up in your wallet.

Do these people ask their other doctors questions like this?

*For my non-North American readers: IHOP (International House of Pancakes) is a restaurant chain in the US and Canada.

Back to Work

Greeted by this headline list on the morning online news:





Hmmm, looks like the headline writer wasn't paying attention in class.

(Please note- this post is to get a giggle off an untimely spelling error. Political comments from either side will not be posted. There are plenty of political blogs for that).

The Tale of the Gold Clip

In honor of Labor Day (celebrated as May Day in other countries) I present this nonpartisan story to remind all of us where our hard-earned tax dollars go. Although I'm American, insanity of this type is universal to all governments, and likely always will be.

I have a gold-colored binder clip on the wall. This is what it looks like:




"Dr. Grumpy, why on Earth would you keep something as odd as a binder clip on your wall?" you ask. So gather round, open up a Diet Coke, and I'll tell you my story.


There have been 3 presidential elections since I went into practice.

During one of these elections a presidential debate was held at a university in my state.

One of my patients is a supervisor at that university's media department. He came in for an appointment, with a bunch of his old test reports. They were held together by a binder-clip. It caught my eye because it was gold-colored (likely made of brass), and I hadn't seen one like that before. I'm used to the standard black clips with silver prongs.

So I mentioned that I'd never seen one like that before, and he told me this story:

When the university was preparing for the presidential debate, the campaigns gave them a list of things the Presidential gentlemen needed on the podium in front of them (the list had been pre-agreed on, so each would have the same stuff).

On top of each podium each Presidential person had paper and pens and a glass of water, which we all saw. But on the shelf underneath the podium, each had the following items, which had been jointly agreed upon. He showed me the memo.

More paper
2 black pens
2 blue pens
3 sharpened No. 2 pencils
A pencil sharpener
Big paper clips
Small paper clips
A stapler
Extra staples
A scotch tape dispenser
An extra role of scotch tape
Yellow post-it notes
Binder clips

So the university dutifully put all this junk on the shelves under each podium, in case either Presidential person wanted to do collating, decorating, or origami on national television.

During the final check of the stage, both campaigns went berserk when they discovered the university had thoughtlessly supplied them with standard black binder clips, as apparently men of Presidential stature should only be using gold-colored binder clips (at least on national television). So the university had to go out and find some (the one I have says 'OfficeMax' on the side) at the last minute.

During the debate, I didn't see either gentleman take any of the above-mentioned items out from the podium. In retrospect, in the 22 Presidential debates I remember seeing in 9 elections, I don't recall seeing anyone using anything from the list other than a pen and paper.

So the university was left with all these office supplies, including gold binder clips.

So now I have the gold binder clip hanging on my wall to remind me of where my hard-earned tax dollars are going.

Sunday, 2:10 pm

"Hello, I need to leave a message for Dr. Grumpy. I'm a patient of his, and the rainstorms we've had this week have been making my migraines terrible! I want to know what he's going to do about it!"

Strange Things To Find In Your Son's Room

Saturday, 4:59 pm

"Hello, this is Mrs. Bimbo, leaving a message for Dr. Grumpy. I'm catching up on my to-do list today, and you guys had called me on August 17, 2009 at 2:17 pm. I don't remember what the message was that you left, so I'd like a call back today to tell me what it concerned and if there was an emergency you needed to discuss with me. Thank you."