Next year, put it in an envelope

Before we met, Mrs. Grumpy was a cancer nurse, specializing in chemotherapy. She worked at the infusion suite of Local Cancer Center.

As you've heard me complain, in December all medical practices get trays of food and/or flowers from different ancillary businesses, thanking them for their support in the past year.

So one busy mid-December morning a delivery guy dropped off a HUGE floral arrangement on the front counter. Since it was busy, and the flowers were pretty, the staff just left them there.

Oncology clinics are never cheerful places, but that morning there seemed to be a larger-than-usual number of patients and their families crying in the lobby. But nobody mentioned anything to the staff, so work went on as usual.

Sometime in the early afternoon a secretary took the flowers back to the break room, so the rest of the staff could enjoy them.

At that point they realized the side of the display that had been facing the lobby had a large note that said:

"Thank you for your referrals over the past year. From the staff at Local Mortuary."

More Gift Ideas

The item has been around for at least 2 years, and always shows up in December. A gift for that truly desperate person in your life.

(click to enlarge)




I've seen various models of it. Another catalog (which Frank colored in, so I couldn't use the picture) had one that actually (I swear!) was powered by AA batteries and said: "It vibrates soothingly, just like a real man!"

I suppose this is true, provided your idea of a "real man" is headless, legless, one-armed, half-torsoed, and "vibrates soothingly".

But if your idea of a "real man" involves vibration and batteries, maybe you should be looking in a different sort of catalog.

Say that again?

From another neurologist's note:

"Clinically, the patient has clinical features of dermatomyositis as noted in clinic today. His clinical exam and lab reports support the clinical diagnosis. So, on a clinical basis, I think he has it."

Chocolates from hell update

The lady who brought the half-eaten chocolates below just came in.

She's blaming it on her teenagers, who were in charge of wrapping gifts, and confessed to her this morning they'd sampled some, then re-closed and wrapped the box.

She is (understandably) mortified.

She's given us a new box, and taken that horror away.

So we're having chocolates and caramel corn for lunch today. With a side of cookies.

Okay, this is just WRONG!

Yesterday one of my patients dropped off a box of chocolates.

This morning the staff unwrapped the paper and opened it.

This is what greeted them.




No more free drug samples for you, lady.

Alzheimer's Disease and the Holidays

We don't decorate for any holiday at my office. This isn't some sort of "Bah! Humbug!" thing as much as we're just too busy to put them up and take them down.

Decor here is fairly spartan. A few generic pictures. On a counter, like most doctors, I have various anatomy models that I use to explain things to patients.

So yesterday afternoon, as I was walking a demented lady back to my exam room, she stopped and looked at them for a minute.

Then she turned to her son and said "Look, Steven, they have Christmas decorations up over here."

Smooth Move, Dr. G.

Tonight Mrs. Grumpy had me stop at Local Deli to pick up dinner.

The glass doors in front are heavily darkened. You can see if there's someone on the other side (so you don't whack them) but they're too dark to make out any details about them.

As I'm leaving with my Bag-O-Dinner, I was starting to push the door open. At the same time a child suddenly appeared on the other side of the door, starting to come in. He jumped back as I pushed the door open, and I almost hit him with it.

I stuck my head out and said, "Oh, sorry, kiddo, I..." and stopped.

It was a midget.

Better late then never

Dr. Grumpy: "Mr. Gregorian, it looks like I saw you once,... back in 2003, and started you on daily Aspirin... and then we never heard from you again. So what brings you in today?"

Mr. Gregorian: "Just following up. You told me to come back in 6 years to check in."

Dr. Grumpy: "Um, it looks like I told you to come back in 6 weeks."

Mr. Gregorian: "Whatever. Anyway, I'm here now."

Mrs. Grumpy is going to kill me

English is an odd language. Being a native speaker, it seems pretty easy to me. But I'm generally lousy at other languages. I took 2 years of Spanish in high school and 4 in college, and I still can't speak it worth crap.

As you guys know, I moonlight doing medical market research interviews. Some are over the internet, some are in person, and some are by phone.

Some of the phone meetings have been outsourced overseas, so occasionally I find myself chatting with someone who speaks English, but with a non-American accent. Occasionally it's someone to whom English is a second language, though usually they're still quite good at it. And that's the situation I found myself in yesterday morning.

The study was on my interactions with drug reps, given by a lady with a mild, nonspecific, accent, but her English was still quite good and understandable. Unfortunately, it was also very old-style, and oddly formal, with phrases and words that aren't used much among modern English speakers. Understandable words, just a little odd.

Most of them were minor, but one was an issue. She used the old word for personal interaction.

Which is "intercourse".

Yes, I know it can mean ANY kind of personal interaction, and the technical phrase for sex is "sexual intercourse". But it's been shortened over time, to where now intercourse just means you're doing the wild thing.

And I'm a veteran of crazy patients, and having to keep a straight face. And I freaking lost it here, (thank heavens for the phone mute button) and at one point had to run to the john to keep from peeing myself (I told her I was going for a Diet Coke).

Here are some of the questions:



"How many times a day do you have intercourse with drug reps?"

My inner voice: It's variable, depending on the time left after I have intercourse with patients.



"If a drug rep provides lunch for your office, are you more likely to have intercourse with them?"

My inner voice: My standards aren't that high. If she's hot, I don't care if she brings prime rib or Taco Bell.



"Do any of your staff members also have intercourse with drug reps?"

My inner voice: Oh yeah, we have a non-stop orgy here. Nowadays I just wear a silk robe to work.



"During intercourse, did the rep provide you with insurance formulary information?"

My inner voice: If she did, I was too preoccupied to notice.



"Following intercourse, did the rep provide you with medication samples?"

My inner voice: No, but we shared a cigarette.



Wait until Mary and Annie find out I had intercourse with a marketing person yesterday. Of course, then I'll be having intercourse with them, too.

More Gift Ideas

My biggest problem with Christmas parties is not knowing what to wear (okay, it's really not a problem at all, because I never get invited to any parties).

But, if you're wondering what to buy your manly man for this holiday season, one of the catalogs had this awesome suggestion.

Let's face it, NOTHING says "seething cauldron of testosterone boiling under the surface" like pink and green giraffes. So get that special stud something that screams "I'M A HOT SEX MACHINE!"

(click to enlarge and induce emesis)

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.


(click to enlarge)

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.