Dear Mr. I.M.A. "Rich" Azzholl, III

I'm sorry about the way things went at your appointment yesterday. I guess you and I just didn't have great chemistry.

I can understand you being frustrated with me. Obviously, a man of your means is used to people kissing his ass constantly. But here at Grumpy Neurology, it doesn't buy you much. Let's face it, Medicare pays me the same amount to put up with you as it pays me to put up with Mr. Nice Butpoor. If you were paying me $1000/hour to listen to your stories about the yacht club I might be more inclined to do so. But I'm only going to get Medicare's flat $115 for you, and my billing company gets 10% of that, and I have to pay Mary, Annie, my rent, the Diet Coke bill, and my malpractice insurance out of the rest.

Anyway, we were obviously off to a bad start when you told Mary that your regular doctor (who you pay cash to) dresses up for you. And this was before you even had a look at me. You also were not happy that, when you asked Mary what kind of refreshments we offer for waiting patients, she pointed to the water cooler.

I SO enjoyed being grilled over my credentials. I really am a doctor, I swear, not some homeless person who decided to rent an office, hire some staff, and buy some cheap office furniture just for the hell of it. You were clearly not impressed that I went through public schooling most of my life. Of course I've heard of your alma mater, but it was so much more fun to watch the horrified expression on your face when I pretended I hadn't, and then asked you if it was in Arkansas. The devil made me do, what else can I say?

I think we reached the low point during the appointment when, after I'd spent 30 minutes taking your windy history, and another 20 minutes examining you, your heavily plasticized wife (who may be putting arsenic in your prunes- watch out) asked me "So when will the doctor come in to talk to us?" That made me feel real special.

So when I heard you tell Mary that you didn't want to schedule a follow-up with me, and wanted to discuss matters with your internist, I knew this translated to "I'm never coming back here and am complaining to my internist about you". And guess what? I don't care.

Be careful the automatic door doesn't hit... oh, sorry, guess I should have warned you sooner.

More Gift Ideas

For those of you still looking for that perfect gift, here's another great idea!

Dogs give you unconditional love, but is that really good enough for you? Wouldn't it be important to know just how many breeds are represented in your mutt? Or is your "purebred" really that? And maybe you'd love your poodle less if you discovered he had a trace of beagle in his lineage?

Wonder no more!

Blood Pressure is Overrated, Anyway

This note was faxed to my office from the patient's family doc this morning.

(click to enlarge)

You Saw It Here First!

My reader Kaitlin notified me yesterday that Dave Barry's column for Sunday, December 6, also featured the nose-shaped soap dispenser that I presented on December 5.

I wish to point out that Dr. Grumpy beat him to press with this important breaking news by several hours, and his column was not leaked to me in advance (unless you consider the catalog being sent to my home to be a leak).

I also am not now, nor have I ever been, Mr. Barry

And I ain't gonna pose in the buff for you guys, either.

Skool Nerse Time

This is Mrs. Grumpy. He didn't want to hear me bitch about my day at the school, and told me to tell you guys. So here.

School nursing brings you an amazing collection of hypochondriacs, and it gets worse with winter break coming and they get restless. So today, besides the usual collection of snotty noses, stomach aches, and "I can't do PE because..." I had this.

Kid #1: "Somethings wrong with my eyes. I can't read the board today."

Me: "Don't you wear glasses?"

Kid#1: "Yeah, but I left them at home."


AND


Kid #2: "I've had this bump on my little finger since I was five, and it looks the same."

Me: "You're ten now. So why are you here?"

Kid#2: "I wanna know what it is."


I also want to thank the 2 teachers (neither of whom was a sub) who sent these kids to my office during regular class time for these complaints.

Whatever

Dr. Grumpy: "Do you have any other medical issues?"

Mrs Barph: "I vomit every afternoon at 3:05 p.m. This started in 1987 and I haven't missed a day since."

I Bet the Cops Love You

Dr. Grumpy: "Sir, why did you call 911?"

Mr. Bozo: "I forgot my doctor's phone number, and thought maybe they would know it, and could call him for me to make an appointment. I need to see him."

More Fun Junkie Quotes

These guys just make a weekend on call so entertaining.


"I've been using crack since I was 18, and I'm 27 now. I mean, that's almost 7 years I've been doing this stuff. I've spent 2 years in jail for it. I've been in and out of every rehab program in town. I've never had a real job, and still live with my parents. It's time for me to turn my life around, and I'm going to start by being honest and telling my parents about my habit. I've been able to hide it from them, but It's time they know I've got a problem."


Dude, if your parents haven't figured that out yet, they're probably on it, too. Also, your math sucks.

Lifestyle Changes

Yesterday I admitted a lady in her 50's who had a stroke. So I'm rounding on her this morning.

Mrs. LDL: "Doctor, I'm changing my whole life right now! I'm going to start being healthy. For many years I've always had a cheese omelet for breakfast. So, today, when they took patient breakfast orders, I realized I had to start doing things differently."

Dr. Grumpy: "Good for you! What did you order?"

Mrs. LDL: "A vegetable omelet, with cheese."

Tis The Catalog Season

With the pentuplet of seasonal holidays approaching (Hanukkah, Festivus, Christmas, Kwanzaa, and Solstice), my home mailbox is full of catalogs selling all kinds of things that these people apparently feel my family and friends can't live without.

Since so many of my patients call my office asking if we have any gift ideas (NO! I HAVE ABSOLUTELY NO FREAKING IDEA WHY THEY CALL ME!!!) I figure many of you are dying to do the same (Dr. Grumpy merchandise is always nice).

So I've personally combed through these many catalogs to help you, my loyal readers, find some of the most useful gifts out there, and will present them over the next few weeks.

Today I'm going to kick off the list with this tasteful item:



Yes, it's a shower soap dispenser (comes with green gel soap! Wow!) that dispenses soap out of it's nostrils. I suppose next year they'll have one that makes a sneezing noise when you squeeze it.

I'd order one for that special coworker who continuously complains about allergies and leaves wadded-up Kleenex all over the office.

Public Service Announcement

Attention ladies:

It is NOT, generally speaking, normal for you to be woken at night by your guy shaking the bed violently, turning blue, and peeing on the sheets. If he does this, and hasn't done it before, he needs medical attention.

You also should not allow this to go on for several nights in a row, and then call his mother to see if she can help you wash all the bedsheets, and (when she asks you why), let her be the one to make the CORRECT decision that he should go to ER.

It is also not cool that you sent him in by himself, so you could stay home and catch up on washing sheets. Your description of the events is usually helpful to those of us in the "med-biz".

Thank you.

Live! From ER! It's Dr. Grumpy!

I'm on call.

While rounding, I was paged overhead to come down to ER for a stroke that had just arrived. Guy who can't move his right side.

So I'm sitting here in ER, watching him from the nurses' station, waiting for my turn to go in. Nurses are hooking him up to stuff, techs in there drawing blood, an EMT going over info with another nurse.

In the middle of this all the patient is lying there, calmly texting with his left hand.

Starting and Ending With a Survey

Well, just as my day began with a strange marketing survey question, apparently it's going to end that way. I'm doing one tonight over the internet, and this question came up:

"When managing a male or female MS patient who wishes to become pregnant, what action do you typically take with their current MS medication?"

You Must Live REALLY Far Away

"I only get migraines when there's a full moon. In my neighborhood I think that's around once a week we have one."