Christmas is coming, the staff are getting fat

(Not to mention Dr. Grumpy)

December, at least for me, is the worst month in my practice. The schedule is usually half-empty as people try to postpone things to after the holidays ("maybe my right arm will start working before the new year"). Patients have a million things come up at the last minute and can't come in. Most irritatingly, my epilepsy patients always get so damn busy that they forget to take their pills, and then have a seizure, and then get angry at me because they can't drive for a month and go Christmas shopping. Like it's MY fault!

But the biggest office issue this time of year is food. The holidays offer a perfect storm.

Like many medical practices, my staff and I depend on drug reps to help supply our nutritive needs. We average 2-3 drug company lunches (occasionally breakfasts) per week, and with the leftovers get 5 days out of it. Sometimes even enough to take home.

But in December, that starts to vanish. Many reps take vacations, or have mandatory time-off. A lot of them find they've gone over-budget for the year, and so to balance it out they cut lunches in December. So we're left with the prospect (gasp!) of foraging for ourselves!

The converging issue that makes this worse is what does come to the office. Every MRI place, lab, physical therapist, pharmacist, and grateful patient sends us trays of stuff. And not healthy stuff, either. Cookies, cakes, pastries, candies, cupcakes, donuts, chocolate covered anything, and other stuff. By the boatload.

So we eat this shit instead. And with fewer patients, we have more time to hang out in the back and chat and eat. And since we are all trying to save money for holiday gifts, we don't want to go get something healthy (like at McD's or Taco Bell).

(There are other options- a diabetes specialist down the hall from me puts all the sweets out in his lobby for the patients. Really.)

So our lunches become a selection of cookies, a few chocolates, and maybe a piece of pie (hey! it's apple pie! Isn't that healthy?).

And it's in this condition that I have to face my evil arch-enemy, the Wii Fit Trainer, who just delights in telling me how much my weight has gone up.

Fortunately I have the new Wii Fit Plus. And so far I've been killed repeatedly by giant wrecking balls on the obstacle course. It's so depressing I'm going to go have a cookie.

Tearing My Hair Out

Dr. Grumpy: "At your last visit you started Inderal for the migraines. Has it helped?"

Mr. Hedhertz: "Nope."

Dr. Grumpy: "Any side effects?"

Mr. Hedhertz: "Nope."

Dr. Grumpy: "What dose did you build up to?"

Mr. Hedhertz: "Um, actually I forgot to get it filled."

Why use your brain when you can buy an EMR and look like an idiot?

This is from a patient note that another doc faxed to my office this morning. The only things I've whited out listed the patient's pharmacies.


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Early Monday at Grumpy's House-of-Brains

When Mary makes reminder calls for the next day she notes on the schedule as to whether she confirmed the appointment with the patient, or a family member, or left them a voice mail, or whatever.

So looking over today's schedule, I saw the following entry:

"1:00 - Suzy Jones, referred for hearing problems. Phone kept ringing, no one answered."

At 5:00 on a Monday morning it gave me the giggles.

Dear Mrs. Nosybich,

Sorry about our little dispute at the school last week. Normally I don't take the kids in the morning, but Mrs. Grumpy had an early meeting that day.

It must be nice having a child that is naturally compliant with your orders. Frank, however, is not like your daughter, and will fight us to the death about wearing a jacket. Getting him to wear a sweatshirt over his clothes took an act of Congress and delicate negotiations. While it's not perfect, it was a halfway compromise.

So far he hasn't frozen to death or caught pneumonia/swine flu/AIDS/cooties/halitosis, or any of the other disorders that you seem to think are floating through the air specifically targeting unjacketed children.

But I'm glad you were concerned enough about someone else's kid to take the time out of your busy day, walk over to me, and make a scene in front of all the other parents about how you've been watching the "horrible neglect" practiced by my wife and I. I appreciate you running down a list of communicable airborne illnesses that you got from Google, and closing your argument by threatening to report us to Child Protective Services if you ever see my kid without a jacket again.

I think it's great that you want to pay such close attention to the failings of us lesser parents. Reminded me of the Charlie Brown cartoon where Lucy took it upon herself to write New Year's Resolution lists for everyone else.

I really like the way you punctuated your tirade by slamming your daughter's car door, HARD, to make sure we were all paying attention. We definitely all were (except your daughter, who looked too terrified to speak) because me, 3 teachers, and 20 other parents immediately began trying to tell you that you'd just slammed one of her backpack straps in the door. But you were clearly more concerned with my crappy parenting skills to notice.

Fortunately, your child had the presence of mind to let go of the other strap after she'd been pulled down and dragged about 3 feet as your drove away. And I have to admire the teacher who boldly leaped in front of your car to make you slam on the brakes, at the risk of her own health.

Your kid will be okay, I swear. She has a small cut on one hand, and a tear in her jacket where it got dragged (maybe you should get her a new one).

I felt so awful about it too. You made me feel very guilty when, after you checked your kid and released the backpack strap from the car door, you turned to me and yelled, "Now look what you made me do!" before getting in your car and driving away.

Happy holidays.

Christmakuh

(I have no idea who wrote this, or where it started. It gets circulated by email so much I'm sure many of you have seen it. But it's still entertaining)

Subject: Holiday News Release

THE NORTH POLE (Reuters) Continuing the economic trend towards monopolies, it was announced today at a press conference that Christmas and Hanukkah will merge. An industry source said that the deal had been in the works for about 1,300 years.

While details were not available at press time, it is believed that the overhead cost of having 12 days of Christmas and 8 days of Hanukkah was becoming prohibitive for both sides. By combining forces the world will be able to enjoy consistent quality service during the 15 Days of Christmukah, as the new holiday is being called.

Massive layoffs are expected, with lords-a-leaping and maids a-milking being the hardest hit.

As part of the agreement, the letters on the dreidl, currently in Hebrew, will be replaced by Latin, thus becoming unintelligible to a wider audience. Also, instead of translating into "A great miracle happened there," the message on the dreidl will be the more generic "Miraculous stuff happens." In exchange, Jews will be allowed to use Santa Claus and his vast merchandising resources for buying and delivering of their gifts.

One of the sticking points holding up the agreement for at least 300 years was the question of whether Jewish children could leave milk and cookies for Santa after having eaten meat for dinner. A breakthrough came last year, when Oreos were finally declared to be kosher. All sides appeared happy about this development except for Santa's dentist.

A spokesman for Christmakuh, Inc., declined to say whether takeovers of Kwanza, Solstice, or Festivus might not be in the works as well. He pointed out that were it not for their independent existences, the merger between Christmas and Hanukkah might be seen as unfair cornering of the holiday market. Fortunately for all concerned, he said, the other holidays will help to maintain the competitive balance.

He then closed the press conference by leading all present in a rousing rendition of "Oy, Come All Ye Faithful."

More Gift Ideas

Hitting the snooze button too many times? Or are you a 4-wheel drive aficionado that thinks every household appliance should be an all-terrain-vehicle? Or both?

Now, you can truly have it all! An alarm clock that not only wakes you up, but leaps off your night table, forcing you to chase it!

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I know this would work at my house, but only once. The alarm might not wake me up, but Blackdog frantically barking at it rolling across the floor would, and then I'd have to get up to clean the puddle where terrified Snowball pissed on the carpet when he thought it was coming to get him. And I wouldn't need to hit the snooze button because in the next minute psycho Cooper would tear it to pieces. And $39.95 seems like a lot of money to me for a 1-time-use appliance.

Suzy Frazzled, M.S.W.

The phones have been ringing busily today, and so a few calls went to voice mail. Annie had me listen to this one. She was laughing so hard she ran to the bathroom so she wouldn't wet herself.

"Hi, this is Suzy Frazzled. I'm a social worker involved in the medical case of Kathy Smith. I'm calling to see if you have any records on her. You probably don't, because none of the other doctors on the list she gave me have ever heard of her, either, and I'm on my last damn nerve dealing with her. Anyway, she's blaming every freaking illness she has, like Fibromyalgia, Restless Leg Syndrome, asthma, arthritis, back pain, irritible bowel syndrome, fatigue, fungal bladder infections, and a bunch of other junk, all on a freaking piece of cotton that was left in her ear 2 years ago after she had a glob of wax taken out. She thinks she's won the freaking lottery, apparently. What? No Bob, I don't have that info here. I've been working on Mrs. Smith all damn morning. How come you don't get these? The boss gives me all this shit, and it's not fair. Where the hell do these people come from and why do they always end up on my freaking desk? Why can't I get normal cases? Oh, sorry, hello? Anyway, please call me back and let me know if you've ever heard of this lady and have a happy holidays."

Spelling Errrorz

Hot off the fax machine this morning! A bunch of notes on a lady, and referral form that says:

"Send patient to a neurologist ASAP. I think she has a stork."


If it's NOT a spelling error, the patient needs either a vet or an OB.

The First Night

The official Grumpy family Christmakuh tree is up, and I want to wish my Jewish readers a very happy Hanukkah.



For those of you unfamiliar with Tom Lehrer's remarkable work, I suggest you learn more. He is one of the very best musical comedians EVER, with, oddly enough, advanced degrees in science and mathematics. Other brilliant works include The Elements, Pollution, Smut, The Hunting Song, I Hold Your Hand in Mine, and many others. For those who (like me) grew up watching The Electric Company on PBS, he wrote a number of those catchy tunes, such as L-Y and Silent E.

Okay, You Can

Dr. Grumpy: "After you hit your head, how long were you unconscious?"

Mr. Dingdong: "1 minute and 14.37 seconds."

Dr. Grumpy "That's pretty precise."

Mr. Dingdong: "I used a stopwatch".

Attention Junkies!

I hate all of you who have impaired my ability to buy enough Sudafed to keep me and my family snot-free during cold season.

Rot in hell, with a cold. And no medications are available for it. Or Kleenex. You can just chap your nose for all eternity with your shirt sleeves. Or worse.

Dear CVS Caremark,

If your specialty pharmacy mail-order branch is handling my patients' potentially dangerous injectable drugs, it would give me (not to mention them) A LOT more confidence if you knew how to spell your own job title.

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Yerz trooly,

Dokter Grumpy.

I Bet He Ain't As Comfortable

Dr. Grumpy: "Is there anything that makes your back pain better?"

Mrs. Lumbar: "Well, my husband has a set of exercise balls, not the huge ones, but the small ones you roll across your muscles, and the pressure from those helps. So I'm able to get comfortable and sleep, but only if I spend the night lying across his balls".