There are Emergencies, and then there are EMERGENCIES!

From an internist's orders on a 34 year old lady admitted with a stroke (she'll be okay, don't worry):

"1. Brain MRI: Routine.

2. Head and neck MRA: Routine.

3. Echocardiogram: Routine.

4. Bring patient some tampons ASAP!!!"

On Call Follies

Dr. Grumpy (starting to look through a chart): "Why did they consult neurology on this guy?"

Nurse: "He had a seizure this morning. Dr. Stevens came by an hour ago, and thought it was from the antibiotic."

Dr. Grumpy: "Hmmm... Why is he in the hospital in the first place?"

Nurse: "Dr. Stevens? Uh, I think he was making rounds."

Life's a Bitch, and Then You Die

I'm on call this weekend, but am going to bitch about something unrelated.

A friend died last week. Not a close friend, or even someone I'd talked to recently. We did residency together, and practiced in the same city. But as time and geography do, we hadn't been in contact for a while. Not that we ever had a falling out, as much as we had our own lives. Occasionally we ran into each other at various places, and it was always good to see him.

He died of shit luck. That's all. And he was in his early 40's, a year younger than me. When a young person dies we always hope they did drugs. Or committed suicide. Or some risky behavior we can blame it on so we can say, "Geez, I don't do that sort of thing, so it won't happen to me". Not here. Just shit luck that can't really be prevented.

In residency we had all kinds of odd adventures, besides the usual war stories of medical training. Like when our hospital paid for the residents to go to a Neurology Academy meeting in Seattle. A bunch of us played hookie, and used our department stipends to go barhopping. Since we had no money for cabs, we were limited to bars in walking distance from our cheap motel. And they were all gaybars. So we wandered in and out of 10-15 gaybars over the course of the day.

All the geeks in neurology residency (let's face it, that was all of us) would watch Babylon 5 together once a week, and he and I would argue about it for the next week.

When I was trying to decide if I should ask Mrs. Grumpy to marry me, he gave me some advice that helped push me in what's turned out to be the right direction.

And it just sucks. Like me, he busted his ass through a combined 14 years of college, med school, residency, and fellowship. Then building a solo practice from scratch. And now he leaves behind a wife and 4 kids (younger than mine, too).

Anyway, don't mean today to be a downer, and I'm not looking for sympathy. Just venting.

But since this is a humor blog, I'll end it with a memory of him.

He was known for being gruff, and didn't really give a shit about what people thought of him or who he offended.

There was a day in the late 90's, when a drug rep had brought lunch to the practice we'd both started out in. She was obnoxious beyond belief. She would not shut up. And at the end of each sentence she'd ask "With this information, is there anything else I can do to help improve your patient care?"

We were trapped. And being new physicians, I was afraid that if we walked out we'd get in trouble, as her company was sponsoring some research at our institution. Gruff wasn't as concerned with this as I was.

So at one point in her sales monologue from hell, I passed him a note that said "We're trapped and will die here". He passed it back, and had written "I'll take care of it".

A second later she asked her standard "With this information, is there anything else I can do to help improve your patient care?"

And Gruff said, "Yeah! Show us your tits!"

She froze in horror, and in that second we both bolted.

We didn't get in trouble. Better yet, we never saw her again, either.

Goodnight, Dr. Gruff.

It's Happened! In My Lifetime! Hallelujah!

Ladies and Gentleman, one of the most horrible, awful, traumatic diseases in history HAS BEEN CURED!

Kapidex is a rehash of Prevacid, a drug used to treat gastric reflux (that's a fancy name for heartburn, huh?)

But Kapidex also treats Non-Erosive Reflux Disease. AKA NERD!!!

(click to enlarge)




There you go! Nerdhood, one of the most socially debilitating diseases known to man, has been CURED!

To give credit where credit is due: this breakthrough wouldn't have been possible without the 1970's efforts of renowned researchers H. Winkler and A. Fonzarelli to bring the condition to widespread public attention.

The data is preliminary, and hopefully more information will be forthcoming. Will the drug cause one to grow a leather jacket? Or make hair follicles part themselves differently? Or alter one's taste in music to something other than "Men Without Hats Greatest Hit?"

And, most importantly, can the drug be dissolved in Diet Coke (uh, not that I'd personally have a reason to want to know that).

(Many thanks to my reader Jason, who sent me the PI for the drug)

Bad Ideas in Currency

A few weeks ago I had a long phone meeting for $275. It was for a market research company, who wanted my opinion on migraine treatments.

So today I received payment from them, with this awesome check;





I was worried the bank teller would hit me over the head 275 times with a hammer. Fortunately, they just credited the money to my account, although the guy began giggling.

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.