Dear Dr. Hummingbird,

What on Earth is your reasoning to take hospital call when you don't want to take care of patients?

I can only assume it's money. Our local community is well aware of your lack of competency, and I don't know anyone who refers to you.

I'm the neurologist on call this weekend, and you ordered 10-15 consults for me, some of which made sense, and some of which were bullshit which defied even the normal boundaries of defensive medicine.

What REALLY chaps my hiney, though, is your uncaring stupidity. Let's review some of the conversations I had with nurses this weekend.


Dr. Grumpy: "This is Dr. Grumpy."

Nurse X: "Yeah, you saw Mrs. Jones this morning, the old lady who can't walk? Dr. Hummingbird told me to call you. She wants to discharge her home if it's okay with you."

Dr. Grumpy: "Is she any better?"

Nurse X: "No she still can't walk. But Dr. Hummingbird said she can lie in bed at home, too."


OR


Dr. Grumpy: "This is Dr. Grumpy."

Nurse Y: "Yeah, you saw Mr. Smith this morning, the man who came in with a TIA? Dr. Hummingbird told me to call you. She wants to discharge him home if it's okay with you."

Dr. Grumpy: "What did his tests show?"

Nurse Y: "He hasn't had any of them yet. Dr. Hummingbird said that since they may not get done until later today, that we should just send him home now because she's got a barbecue to go to this afternoon, and won't be here to write discharge orders."


OR


Dr. Grumpy: "This is Dr. Grumpy."

Nurse Z: "Yeah, you saw Mrs. Stevens this morning for her left hand pain? She's now having severe stomach pain, and had a stool with a lot of blood in it."

Dr. Grumpy: "Why are you calling me?"

Nurse Z: "Dr. Hummingbird told me to call you. She said that since the patient has a neurological issue with her hand that's she's uncomfortable managing any aspect of her care and that you should deal with whatever comes up".



I have nothing against these nurses. They know you for who you are, too, and are stuck because you ordered them to make these inane calls to me.

I'd like to blame this on your lack of experience, or just having a crappy weekend, but this happens every time I wind up on call with you, and my call partners say similarly flattering things about you. And you've been doing this crap for 8 years now.

Thank you for this interesting consult.

More Junkie Logic

Just a weekend of remarkable quotes. I couldn't make this stuff up if I tried.


"I was on my way to my girlfriend's place and did some meth in the car because if I waited till I got there she and her roommate might use it all. But there was something wrong with it and I began shaking, and got real dizzy, and then began puking all over the steering wheel. Then my vision got blurry and I couldn't see the road very well, and I was afraid to pull over cause then a cop might come try to help me, and I'd be in deep shit, so to be safe I started driving as fast as I could to get to the nearest emergency room."

Not Helpful, Either

From a lady I'm seeing at the hospital today, trying to get a list of what she's taking:

"I take that store-brand medicine. It's for a runny nose, or cough, or allergies, something like that. You know what I mean, all the stores have it."

On Call, With Junkies

"I got paid yesterday, so I thought I'd do some crack. I couldn't find my regular dealer, and I called, like, every number I had. Anyway, one of the guys I work with at BK had a friend who knew a dealer, and got me the number, so I bought some from her. But it made me all sick and shit, and that's why I ended up here. It was some seriously bad shit, and wasn't safe at all to be selling it, and that bitch should have known better. That's the whole problem with the world today. My regular dealer has a lot of integrity, but this bitch who I bought it from, I mean, it's just fucked up because a lot of people are getting into drug dealing today just for the money, and don't give a shit about customers like me. And that's just wrong."

Trying Not to Laugh

Mrs. Daughter: "Dad, did you forget to wear your hearing aids today?"

Mr. Olde: "What?"

Not Helpful

Dr. Grumpy: "Let me get an MRI form... Do you have metal anywhere in your body?"

Mr. Irrelevant: "Nope. My wife does, though. She has a pacemaker. And my oldest daughter has an artificial hip. And my brother has a bullet from Korea in one arm. And..."

I'll Leave Things As They Are, Thanks

We get these junk faxes advertising great prices on medical supplies, office equipment, temp help, software, medications, office catering, everything.

So this one came over a few minutes ago from a company called The Physicians Exchange, for a phone answering service.

I think they need to get a better website address.....

(click to enlarge)

Darwin, Halloween, and the Theory of Evolution

The week after Halloween is the ideal time to prove evolution.

Certain species of bugs have developed a really bad taste so predators won't eat them (at least, that's what I've read. I haven't personally done insect taste tests).

Did they actually evolve in that direction? What is the evidence?

Let's look in Dr. Grumpy's break room:


Post Halloween day #1: Everyone brings/dumps their leftover candy at the office. We put it in a big bowl in the break room. We are too damn sick of candy to touch it.

Post Halloween days #2-3: Predators (okay, me and the staff) arrive. The choicest (i.e., chocolate) items disappear first. Reese's PB cups, M&Ms, Milky Way, Snickers, Kit-Kats, Twixt, Butterfingers, Three Musketeers.

Post Halloween days #4-5: Other stuff starts to go. Skittles, Laffy Taffy, Smarties, Starbursts.

Post Halloween days #6 and on: This is when we find the survivors. Just like the unpalatable bugs, some candy types will sit there for quite a while. Candy Corn, Circus Peanuts, Tootsie Rolls, hard suckers, and those horrible taffy things in black and orange wrappers (the latter, I suspect, were only made once in the 1960's and have since just been re-gifted. I think people who got them as kids now give them out as adults, and the cycle continues).


Granted, I have no evidence to suggest that Darwin's staff dumped leftover candy at the office. If they did, however I'd suspect that's more likely to have led him to the theory of evolution than a trip to the Galapagos.

Cause and Effect

From yesterday afternoon:

Mrs. Hedake: "They painted my office building last month, and I just know that's what's causing my migraines."

Dr. Grumpy: "How long have you had migraines?"

Mrs. Hedake: "I've had daily migraines since 1995."

Dr. Grumpy: "Have they changed since the building was painted?"

Mrs. Hedake: "No. Same type as before."

Dr. Grumpy: "Then why do you feel the paint has affected them?"

Mrs. Hedake: "Because I think they'd have gone away if they hadn't painted it."

Survey Fun

I'm doing an early morning market research phone survey about a new drug in development. The guy just asked me this question:

"Do you prefer prescribing drugs that are more effective? Or less effective?"

You Don't Say!

Okay, Grumpyites.

Our Science Marches on Department has brought this earth-shattering research to my attention.

In today's edition of ScienceDaily.com a study was published which found that...

(drumroll please)

PEOPLE WHO DRINK COFFEE (or use caffeine in general) BEFORE THEY TRY TO SLEEP HAVE TROUBLE SLEEPING!!!

This is not a joke. They kept a bunch of people up all night. 3 hours before they were allowed to sleep half of them took a 200mg caffeine pill (equivalent to 2 cups of coffee or 5 Diet Cokes) and the other half didn't get caffeine.

They found (sarcastic astonishment) that the patients who got the caffeine had more trouble sleeping than the ones who didn't! No shit!

I am not making this up. Here's the link.

Does Anyone Read My Notes?

Dear Dr. Bozo,

I'm not sure if you're lazy, or stupid, or too busy, or all of the above.

I appreciate you sending Mrs. Oldlady to me. Her symptoms certainly were concerning for a TIA, so I ordered a work-up.

Her MRI yesterday showed a small right brain stroke, while the MRA showed a critically narrowed right carotid artery.

I saw her urgently this morning, and set up plans to change her medications and to see a vascular surgeon. After she left I quickly typed up a letter to you summarizing my plan. Since I believe in good communication, I faxed over all the MRI/MRA reports with my letter.

I therefore found it comical that about an hour after I faxed it over, your office immediately faxed the MRI report AND MY OWN NOTES back to me, with your handwriting on the report saying "HAS HAD STROKE! GET HER INTO A NEUROLOGIST ASAP!"

My Readers Write

Given that my name is Ibee Grumpy, you'd think I'd be the last person to laugh at someone else's name.

But, since my alert reader Stephanie brought this to my attention, I thought I should share it with all of you (I should be above such juvenile humor, but I'm not). I suspect this group is known in local circles, but...

Anyway, this is a Urology group in Texas, whose members include Dr. Wang, Dr. Hardemann, and (of course) Dr. Dick Chopp.



Sorry, Drs. Wang, Hardemann, and Chopp, but I'm sure you guys hear the jokes all the time. Plus, there's no such thing as bad publicity!

For those of you who don't believe me, here's their website.

And a great big Dr. Grumpy thank you to Stephanie!

No, You Can Do That Yourself

I'm examining a guy this morning who's chewing a toothpick, repeatedly doing the thing where he turns it around in his mouth, then gnawing on it some more.

I asked him to open his mouth and stick out his tongue.

So he takes the spit-covered, chewed-up, soggy toothpick out of his mouth, holds it out, and says "Can you hold this for me?"