Progress Note Addendum

William, a medical student, has submitted the following, more detailed, chart for your perusal.

I still think we neurologists should have a special "Freaks and Greeks" heading for our field, though.

Thank you, William!

(click to enlarge)

Why Did You Decide To Become a Neurologist?

I get that question a lot, people wondering why I'm a doctor, how I got into neurology, if this is my real hair or just a cheap rug, and... but I digress.

Anyway, I'd like to present this flow chart which explains the complex process by which a medical student (sort of like a stem cell) eventually transforms into their specific field. It was sent to me by an anonymous reader, so thank you whoever you are.

You'll notice neurology isn't listed here, likely due to space constraints. I'd put it somewhere under internal medicine, with a special "Freaks and Geeks" section leading to my field.

(click to enlarge)

Turkee and Grayvie! Yum!

Alright, my kids school district sent a flyer home with them tonight.

They're having a Thanksgiving lunch next week, and are inviting parents to join their kids at it. The flyer included the following:


"Please join you child during they're regular lunch schedule"

"Includes choice of desert" (Sonoran? Sahara? Gobi?)

"Sliced turkey brest"

Holy Electric Boner Batman!

The Science Marches on Department has brought the following medical research breakthrough to my attention:


Penile Shockwave Therapy Shows Promise For Erectile Dysfunction

Thursday Morning 2:48 a.m.

Today's Quiz

I (and most of my neighborhood) were blasted out of bed this morning.

I was woken by:

A. Phone call from a deranged patient.

B. Phone call from a frantic ER doc.

C. Phone call from a bored nurse.

D. My 8-year-old son Craig, who for whatever reason thought it would be funny to turn on his CD player in the middle of the night, playing "YMCA" at full volume.

(If you guessed "D", congratulations! And I had no idea Mrs. Grumpy and the neighbors even read this).

It's fun to stay at the...

That's The Way It Is

My esteemed colleague ERP put this up today, and I thought it was worth sharing.

Family Math Issues

Mrs. Hyper: "I have 3 kids."

Dr. Grumpy: "That's nice. Boys? Girls?"

Mrs. Hyper: "One of each."

Dear Mr. Attorney,

I appreciate you sending payment for Mrs. Jones' medical records.

As you know, her chart was quite large, so printing it up took quite a bit of time and paper. You also wanted me to have it notarized, so I had to drag it down to Local Bank and wait in line.

Then postage was a fortune, since you wanted it sent certified.

Anyway, because it took some time and effort, I enclosed a cover letter asking for $50 payment. Your office manager was kind enough to send me a check for $50 last month to cover this, on the same day she received the packet.

So it was quite a surprise to get a personal note from you yesterday, saying that you felt the $50 was excessive. You did some calculations in your letter, and said that (based on state law) you only owed me $27.45, instead of the $50 I'd previously asked for (and received).

But it was still nice of you to send a check for $27.45 attached to your letter, paying me what you thought was "reasonable, and more than fair" for Mrs. Jones' records.

I've deposited both checks, and thank you and your law firm for having paid me a total of $77.45 for a chart I'd only asked $50 for in the first place. Extra money around the holidays is always nice.

Yours truly,

Ibee Grumpy, M.D.

Packing Overkill

One of the things that drives me nuts is shipping stuff. Not mailing stuff out, though that can be a pain, but more the way stuff gets sent to me in containers that are insanely out of proportion.

Lets take Axert. This is a migraine drug that has no drug reps. So when I need samples I have to call them, asking them to ship me some.

Last week I called for samples, and they showed up today. It comes in a blue and yellow package with 4 little tablet packages in it. But it always ships in a freaking HUGE box, surrounded by a crapload of paper, like 2-5 trees worth.

So here's a picture of the entire Axert package and the box it was shipped in. I put a Diet Coke in the picture to give you some idea of size.




Of course, the Axert people aren't the only ones guilty of this insanity. I have a patient coming in for Botox injections later this week, so I ordered a bottle. ONE dinky bottle (which is freaking $560, too). Now, I understand Botox has to be kept cold during overnight shipping, and needs some styrofoam and ice, but even still the shipping seems to be a little excessive. So here, for your perusal, is a bottle of Botox, the box it came in, and another Diet Coke.





So, now you know how many trees it takes to ship a package of Axert or bottle of Botox.

Crap! That Hurts!

Purell- It isn't just a great hand sanitizer anymore.

It also does a fucking AWESOME job of letting you know where every single damn cut & skin crack is on your hands.

Tuesday Morning, 1:58 a.m.

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mr. Sleepless: "Hi, I take Compazine for nausea, and wanted to know if it's safe to take with my epilepsy?"

Dr. Grumpy: "Haven't you taken it as needed for several years? It's never caused you to have a seizure before, has it?"

Mr. Sleepless: "No, never had a problem before, and I've been using it here and there since the mid-90's"

Dr. Grumpy: "Then it shouldn't be a problem."

Mr. Sleepless: "Oh good. Sorry to bother you, but I couldn't sleep, so I started googling all my medicines, and saw that Compazine could do this."

Um, Okay...

Mr. Hedhurtz: "I had a horrible migraine this weekend. Worst I've had in years. It was so bad I was thinking of going to the emergency room."

Dr. Grumpy: "Did you?"

Mr. Hedhurtz: "No, I went to the casino instead."

Damnit, Jim, I'm a Doctor, Not an Electrician

I finally had the time today to fire up the Grumpy family hot tub for the winter.

So I cleaned it out, filled it up, added chemicals, put in a new filter, etc.

For whatever reason, though, I couldn't find the power cord that comes with it. Because I'm a guy (and therefore inherently stupid) I just grabbed an extension cord out of the garage. Mrs. Grumpy kept telling me I wasn't supposed to do that, because the special hot tub cord had extra circuits or fuses or breakers or whatever in it, and you couldn't use something else.

But I wanted to get the hot tub going, so I told her it would be fine, and hooked it up.

The kids were excited, so I had them out in the yard with me. They counted down from 10 for me to flip the switch, turning it on for the winter.

"5-4-3-2-1- HOT TUB!". I pressed the button. The jets whirled, the water swirled, the kids laughed.

For about 5 seconds.

Then there was a loud "POP!"

And the hot tub turned off.

And the kids stopped laughing.

And all the lights in the house went out.

Another 5-10 seconds of absolute silence went by, finally broken by Mrs. Grumpy saying "You bozo."

She went around to futz with the switch box. She found the correct power cord in the garage. And I am in trouble.

Sunday Reading

Catching up on some reading today and found:

A study on patients with bleeding into the brain, which found that patients with only 1 type of brain hemorrhage had a better prognosis than patients with 2 types of brain hemorrhages.

Really. I'm not making this up. Archives of Neurology, January 2009, page 79.