From Hawaii, With Love

When the kids were younger, we had a part-time nanny named Syndee. I was anything but fond of her. I don't remember how Mrs. Grumpy found her.

Syndee did a good job with the kids, so I turned a blind eye to her many shortcomings (which could be several posts alone). Her main issue was a remarkable lack of IQ and common sense. It was not uncommon to realize she'd been outsmarted by Snowball (and he's slow). She occasionally still calls to see if we need a babysitter. Rarely she'll call me for medical questions, as she does not grasp the concept of what being a specialist means. She's also learned (since she knows our home number) that it's easier to reach me then her own doctor.

Last week Syndee got married, and went off to Hawaii for her honeymoon.

This morning, at 12:05 a.m., I was woken by our home phone ringing.

Dr. Grumpy: "Mmmph, hello?"

Syndee: "Hi! Dr. Grumpy! It's me, Syndee!"

Dr. Grumpy: "What the hell?... Syndee do you know what time it is?"

Syndee: "Sure! It's just after dinner! Why, is your clock broken?"

Dr. Grumpy: "No, it's after midnight here."

Syndee: "It is not! I wouldn't call that late!"

Dr. Grumpy: "Syndee, you're in another time zone."

Syndee: "What's a time zone?"

Dr. Grumpy (sigh): "Why did you call Syndee?"

Syndee: "Well, um, In the last few days I've developed a bladder infection and..."

Dr. Grumpy (seeing an opportunity to get even): "What the HELL have you been doing on your honeymoon to get a bladder infection?"

Syndee: "Well, um, my husband and me, um we, um... Can you just call in some antibiotics for me?"

Dr. Grumpy: "Why didn't you call your regular doctor for this?"

Syndee: "Her office was closed, and I didn't want to bother her."

Dr. Grumpy: "Good night, Syndee." (hangs up)

Tricky Case

I just got interrupted for a call from the ER.

68 year old male.

Family noticed he's staggering today, and has slurred speech. They brought him to ER.

Head CT, EKG, all labs normal EXCEPT for a blood alcohol level of 0.277 (which is more than 3 times the legal limit).

AND HIS INTERNIST WANTS ME TO COME ADMIT HIM FOR A STROKE!!!!!!!!!!!!!!!!!!!

Geography FAIL!

I had an elderly couple here this morning. They're going to Florida in a few weeks, and asked for an Aricept script to take with them.


Dr. Grumpy: "Why, don't you have enough pills?"

Mrs. Mapquest: "Well, it's so expensive, and we're in the Medicare donut hole. We thought maybe one day we could go over to Cuba to see if it's cheaper there."

Dr. Grumpy: "Have you ever been to Florida? Or Cuba?"

Mrs. Mapquest: "No, but isn't it like Mexico or Canada, where you can just walk across the border?"

Parks for Vampires

It's Fall Break. So I knocked off early today to take the kids hiking, and drove to Intheforest State Park.

Most state parks here are open from 10:00 a.m. to dusk, but they change opening/closing times as the seasons change.

So when we got up to the park we were greeted by this sign:




Your tax dollars hard at work.

Do I Look Like the Shell Answer Man?

Dr. Grumpy: "Any other questions about this medication?"

Mr. Irritant: "No, but my wife and I were looking into adopting a child from Guatemala. Do you know how I'd reach their embassy for more information?"

Dear Smuckers,

The bozo in your "Sundae Syrup" division who developed your "No Mess Cap" bottle has obviously not met my kids.

This is false advertising, and I'm sending you the bill for having to repaint my kitchen.

Yours truly,

Ibee Grumpy, M.D.

Thanks, But I'm Washing My Hair That Night

For those of you who missed my post on the Alzheimer's Disease Luau:

A rep for a Parkinson's Disease drug dropped off an invite this morning (I'd put it up, but it was so full of potentially identifying info that I couldn't adequately censure it without ruining the effect, so you just get a summary).

It was an invitation to attend the "Park-toberfest" celebration.

Featuring:

"Opportunities to mingle with Parkinson's patients and their families" (I already do this at work!)

"A local band composed entirely of Parkinson's patients" (No comment)

"Relax with other neurologists" (I'd rather have Cooper chew my scrotum off, thank you.)

"A fine selection of Bavarian beers" (I can just see this: "Haven't you had too many drinks, Sir?", "No, Doc, it's my first one. I just forgot my Sinemet dose."

I'm sure my pharmacy readers will also consider the possibility of mixing alcohol with Selegiline.....

Dr. Grumpy Regrets...

I'm sorry to inform my readers that today's attempt to turn the weird drug company gadget into a fish tank ended in disaster.

While trying to loosen the lid (representing an outer layer of skin) the entire thing shattered into a bazillion pieces of plastic and rubber.

Ed will therefore be remaining in his usual home.

Doritos! She Wants Doritos!

So tonight Mrs. Grumpy and I went to a Thai place for dinner.

A group of 8 came in, and were seated near us. They provided the entertainment for the evening. Mrs. Grumpy knows it's a bad sign when I start taking notes.

They'd never had Thai food before, and found the menu befuddling. One lady asked where the hamburger section of the menu was. Another was under the impression that all Thai food was like the Thai chicken pizza he gets at California Pizza Kitchen, and began arguing with the wattress about "how come you don't have pizza! You're a Thai restaurant for Pete's sake!"

After a woman at one end of the table ordered something, the waitress asked if she wanted rice or noodles with it. The woman, I swear, said "Um, I don't like either. Can I get some Doritos instead?"

But the best part came when their conversation turned to healthy eating. One woman wanted to know why no one had invented a pill that blocks caffeine. That way you could have a Coke, and take this pill, and not have the effects of caffeine. Obviously, drinking caffeine-free Coke was too complex for her.

AND THEN I heard the name of one of my stroke patients. It was something like this:

"How's Phil doing?"

"Oh, he's okay. You know how Phil is. He's just ignoring advice and trying to do this on his own."

"I thought he was in rehab?"

"He is, and those idiot doctors are doing physical therapy and other stuff, like that's going to help. I went by and gave him a bunch of info on how all he really needs to do is take some vitamin B6 and ginger tea to get his left side working again, but he won't listen to me. He acts like these doctors know what they're doing."

I'll swing by and see Phil on Monday.

Saturday Morning, 6:19 a.m.

"Hi, this is Mr. Noclue. I have an appointment with Dr. Grumpy today, and I'm not going to make it because I have another appointment and, what?..........Oh, my wife says today is Saturday, and my other appointment is next week, so I guess I will be able to come see you today............ my wife says you're probably not open on Saturday either, so I'm going to go find my calendar to see when my appointment is and will call you back".

Mary's Desk, October 9, 2009

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

Mrs. Parent: "Hi. My 13 year old son needs to see a neurologist."

Mary: "I'm sorry. Dr. Grumpy doesn't see anyone under 18."

Mrs. Parent: "Oh... But we'd heard such good things about him, too."

Mary: "I'm sorry. We recommend Pediatric Neurology, Inc."

Mrs. Parent: "Okay. But when my son turns 18, can he see Dr. Grumpy then?"

Mary: "Of course."

Mrs. Parent: "Can I make that appointment now?"

Early Morning in Grumpyland

So following the time-honored tradition of my Bible (Chapter 20- Execute Forms at Dawn) I'm sitting here doing miscellaneous paperwork.

For those of you who have never had to deal with employer health forms, they are a freaking nightmare. A remarkable collection of stupid questions, redundancy, and more redundancy.

Today I'm completing job forms for one of my epilepsy patients, who works in sales. Questions from his employer include:

Is Mr. Shakes capable of working in sales during a seizure? (depends on what he's selling)

Would a seizure at work impair Mr. Shakes' job performance? (No! Who could resist an unconscious salesman who just wet himself?)

Will Mr. Shakes need to leave work to attend doctor appointments? (Of course not, I'll just swing by in the Grumpymobile)

If Mr. Shakes has a seizure, will it be necessary for him to leave work? (No, just leave him lying in the aisle)

Between seizures, is it safe for Mr. Shakes to operate a golf cart for clients (NO! Wait till he's having a seizure, THEN let him operate it)

Feeling Down?

Hot off the fax machine! Invite to a drug company dinner meeting about Cymbalta.

With a typo...

It says the topic is "Treating Depression with Cumbalta"

Thanks, Nurse X.

A common method of non-urgent hospital communication between doctors and nurses is the post-it note. I'll open a chart, and find a post-it in the progress notes saying: "Dr.- Can patient take his fish oil pills from home?" or "Dr.- Patient says she also takes Synthroid. Can you please order this?"

So this afternoon on rounds I found the following note in one of my hospital patient's charts. (NOTE- for my non-medical readers, PRN means "when needed")




Hmmm. That depends, Nurse. What are you planning on doing with him?