Thanks, Craig

When I was young and active (i.e. before kids) I played pick-up basketball a lot. So I have a bunch of raggy mens tank-tops in my closet from those days.



I don't wear them anymore, because (between them shrinking and me expanding) they show off my midriff, sort of an unsexy Britney Spears look.

So yesterday afternoon Craig found one in my closet, held it up, and said "Dad, why do you own a dress?"

My Readers Write

I have the most boring lobby in the world. Chairs, table, water cooler, some magazines. If you want to wait amongst plasma screen TV's, Louvre-quality paintings, and free Wi-Fi, go see Dr. Bigtitz, the plastic surgeon upstairs.

I follow the advice of The Bible - no mirrors, clocks, or music out there.

Anyway, I'm rambling about this because last week I received an email from Dr. Stingray, who says he's an internist in Florida, commenting on office decor issues:

"Years ago I subleased from a neurologist, Dr. Sousaphone. He only saw Alzheimer's patients, and believed in having an office that would rival any art museum.

"One day, for whatever reason, he decided to install a fountain in the lobby. This wasn't some little desktop thing, but a fairly large contraption of copper and stone. He thought its gentle sounds would relax his demented patients.

"Unfortunately, it was more relaxing then he'd anticipated. 2 days after it's debut an elderly, demented man (to his wife's horror) walked over to it, unzipped, and drained his bladder into the relaxing waters. Another disinhibited gentleman thought this was a good idea and promptly joined him.

"This performance stunned Dr. Sousaphone (not to mention my waiting patients) who hadn't anticipated the fountain's effect on demented males with enlarged prostates. After they cleaned the fountain he had a sign installed that said "Please do not urinate in the fountain. It is for decoration only" (Dr. Grumpy comments: Wow! If you saw that sign in your doctor's lobby, what would you think?).

"The effectiveness of the sign was matched only by his patients' fading memories, and after 3 weeks Dr. Sousaphone's staff got sick of cleaning the fountain and made him remove it."

Mrs. Grumpy Hates Me

Tonight Mrs. Grumpy took me and the tribe to an outdoor party for the kids at the school where she works.

So we're sitting up in the bleachers watching a free-for-all volleyball game with about 50 kids on each side hitting these HUGE oversized beach balls back and forth. While this is going on the Principal comes over, and Mrs. Grumpy introduces us.

Then Ms. Principal looks out at the game and says "those are the biggest balls I've ever seen."

I said "Why, thank you."

I'll be sleeping on the couch tonight. Possibly longer.

Where Am We?

Introduction: Mr. Fried, a pleasant refugee of the 60's (think Reverend Jim, from "Taxi"), saw me 8 years ago, when he used to live here. He then moved away, but recently moved back and came in to re-establish care. Please note the state names have been changed to protect the identities of myself and the states. Mr. Fried needs no protection, as he has no idea who he is anyway.


Dr. Grumpy: "Good to see you again, Mr. Fried."

Mr. Fried: "It's good to be back in Minnesota, Doc".

Dr. Grumpy: "We're in Oregon, sir."

Mr. Fried: "Yeah, that's what I meant."

Dr. Grumpy: "So I last saw you in 2001, before you moved to Alabama."

Mr. Fried: "I didn't know you moved to Alabama. I was living there, too."

Dr. Grumpy: "No, I was here in Oregon the whole time. You moved."

Mr. Fried: "I know. I miss Minnesota already."

Dr. Grumpy: "How are your headaches?"

Mr. Fried: "Are they why I moved to Alabama?"

Dr. Grumpy: "I have no idea."

Mr. Fried: "Do you know if I had them when I lived in Minnesota?"

Dr. Grumpy: "Mr. Fried, I've never lived in Minnesota."

Mr. Fried: "Neither have I."


It was a really long hour.

Life in Retail

(Annie's daughter, Evie, started working at Target this week. Today Annie sent me this email about how she's doing)

"This is Evie's first retail experience. They have her managing lingerie.

"Yesterday, they had a corporate head guy come through at 10 am. The store manager told her at 8am there was to be this surprise inspection at 10 and unfortunately the night crew had left 5 full carts of merchandise in her department to be tagged and shelved. He knew it was not fair, but he needed it done.

"She got it done, but just as the head guy was coming to her department here comes a woman with 5 unruly kids. Knocking over the racks, grabbing the bras and screaming "look mom I have boobs". Horrified store manager got the bigwigs to move on while kids continued to destroy department. Mom of the kids went into melt down and started beating them all with both her purse and one she grabbed off a rack.

"An hour later, while trying to help an elderly woman on a cane, who could not find the type of bras from her day... Evie innocently asked 'well could you try and describe it to me so I can help you find something like it'. The woman lifted up her shirt to show her the bra she wanted.

"Welcome to retail."

Helpful Radiology Results

This report came over the fax today:

"Impression: When compared to the previous study of January, 2009, the right carotid artery stenosis has significantly worsened and is entirely unchanged."

I'm Impressed

My 9:00 patient this morning called at 8:45. Said she was having "car trouble", and asked if she could reschedule to later in the morning. So we moved her to 11:15.

She shows up at 11:15, with her forehead and arms darkened, smelling strongly of smoke.

She apologized for not having had a chance to shower, but by the time she gave up on trying to put out the car herself, and the fire department left after doing so, and she found a friend to give her a ride here, she just didn't have time.

Two points:

1. I am in AWE at your devotion to me that you only moved the appointment 135 minutes, instead of to next week or month.

2. When the fire department is putting out your car, I consider that beyond "car trouble". I'd have been running in circles & screaming, and likely wouldn't have bothered to call my doctor about the appointment under the circumstances.

Mary's Desk, September 16, 2009

Mary: "Dr. Grumpy's office. This is Mary."

Mr. Needshelp: "Hi! I need to make an appointment to see Dr. Grumpy!"

Mary: "Okay. When would you like to come in?"

Mr. Needshelp: "Um, I don't know, you mean to come see the Doctor?"

Mary: "Yes. You said you wanted to make an appointment?"

Mr. Needshelp: "I do, but, um, I don't think I'm quite ready to actually schedule it. I'll call back another day. Thank you!"

Public Service Announcement

If you (hypothetically, of course) get a can of Diet Coke that has lost some taste due to sitting in a garage for too long, DO NOT pour a packet of sweetener into it.

The resulting reaction will cause the soda to foam up wildly, going all over your desk, keyboard, pens, MRI reports, notes, and anything else.

The tissue box on your desk will likely not have enough in it to stop it from pouring on the floor.

The patient across from you will be of no help whatsoever, and may post about it tonight on grumpypatientblog.com.

Again, this is a purely hypothetical situation.

Thank you.

What Does a Neurology Exam Involve?

Several of you have written in to ask what a neurology exam involves, and how it differs from what your regular doctor may do.

Neurologists learn to do very detailed exams, studying reflexes, strength, coordination, and many other systems. These involve great skill in noticing important, sometimes subtle, details.

To give you an example, today I was reviewing some notes from a neurologist across town. Here is a detailed complete neuro exam from her note:





Obviously, it takes years of training, and a great deal of time, to notice things like this.

To give you a more thorough picture, here is another very detailed exam by the same doctor on the same patient, done 1 month after the initial visit. Notice how she carefully documents changes in his condition:





So that's what a neurology exam involves.

Because We're Nuts, That's Why

Yours truly was asked to write a guest post over at "Ask an MD" about why neurologists are so strange (good question, too).

So to see my answer (which really boils down to "I have no freakin' idea"), click here.

Drug Rep Sunshine

Ms. Sunshine: "Doctor, Fukitol is the most prescribed drug in it's class."

Me: "Fukitol is the ONLY drug in it's class!"

Ms. Sunshine: "Um, yeah."

Welcome to McGrumpys, May I Take Your Order?

"Hi, I'm on my way there for an 8:00 appointment. Anyway, I didn't have time to eat breakfast, and am hungry. Do you guys serve food in your office? And if you have bagels, what kinds?"


WTF? Am I a Marriott?

Take Her Down, Helmsman

People use different phrases to mean the same thing. Case in point: migraines.

Some patients say "I have migraines". Others say "I get migraines". Occasionally one will use the odd phrase (at least to me) "I take migraines" to mean the same thing (I always want to ask who they're taking them from).

But today I had a lady who used a more, uh interesting, phrase.

When she gets a migraine she has to go lie down in a dark room (which is common). So, for whatever reason, she uses this act to refer to the migraine.

In other words: when she gets a migraine, she calls it "going down".

It is remarkably hard to keep a straight face when the young lady across from me says things like:

"I went down 3 times last week."

"July was awful. I spent the entire month going down".

"I went down on Saturday. I had to do it in front of my kids, too."

And, as she was leaving, she said, "I feel another one coming on. I just know I'll be going down tonight, but have to wait until my husband gets home."

No comment.