Things that make me grumpy

I had a consult for Parkinson's disease over at Local Rehab hospital today. So I dragged my butt out of bed on Sunday and drove over there.

Parkinson's patients, unless they live in the boondocks, generally have a neurologist. Most PCP's don't want to manage this (nor should they). So when I see a Parkie in the hospital I always ask them who their regular neurologist is.

And this lady told me it was Dr. Osa, who works across the street from the rehab hospital and goes there to round. He's been following her for 5 years.

So I went back to her chart, and reviewed the records. She was recently hospitalized for hip surgery, and during the hospital stay Dr. Osa saw her EVERY FREAKING DAY and, as a consultant his name was printed at the top of every damn page of her hospital stay. But Dr. Fruitcake, who's following her in rehab, somehow didn't notice that minor detail.

So I went back and asked the patient. Did you tell Dr. Fruitcake you see Dr. Osa? "Of course I did, but she never payed attention. She just said she'd have a neurologist come see me."

So I asked the charge nurse. Did Dr. Fruitcake even look at the hospital records? "Of course. I handed them to her myself. She gave them back to me and said to put them in the chart. She told me that she never wastes time looking at hospital records because she has a busy life."

I changed the consult to Dr. Osa, and called him myself. He'll be in later today.

I drove home, an hour wasted.

Dr. Fruitcake, READ THE FUCKING CHART. If you don't have time to take proper care of patients then get out of medicine.

More Gift Ideas

Santa Claus.

The embodiment of holiday cheer. One of December's most endearing legends. A great way (at least to try) to keep your kids in line year round ("you're gonna get coal if you don't stop that!").

So what could be more appropriate, joyful, or holiday-esque than this?

(click to enlarge)

Winter Vacation, Day 1, 7:09 a.m.

And it was clean last night. Yes, that's part of the Christmakuh tree.

December, 1974

I hadn't been in a hospital since I was born, and of course I don't remember that.

But my asthma was not getting better that week (I was on Marax- you RPh people remember that?) and so, after repeated visits to his office, my pediatrician admitted me to Local Hospital.

My most vivid memory is watching "The Year Without a Santa Claus" on TV ("I'll have a blue Christmas without you...). It was the only thing I remember being on. Maybe that's why, ever since then, I've been oddly partial to the "I'm Mr. White/Green Christmas" musical numbers.

Yes, kids, back then you had to PLAN your holiday-TV-special-watching. It wasn't as simple as just, say, finding which of the 182 channels were showing it on any given night, or popping the DVD in whenever you wanted. A motivation to learn to read was so you could look through TV Guide and make a list of when and what channel each of the key specials was on. Because if you missed them, too bad. They wouldn't be back until next year. So, no matter where you were, you found a way to watch them.

I also had to learn to pee in a urinal. But, I digress.

I thought I was a good patient. I really did. I don't remember pressing the call button much. My breathing got better. I went home the next day.

And now let's fast-forward to the mid-90's.

Studly, white-coated, intern Dr. Grumpy, fresh out of med-school, is now doing his training at the very same hospital where he spent that night long ago. And one day, while waiting for an admission to come out of the MRI, he wanders down to medical records, looking for that long ago chart from 1974.

Down 2 flights of stairs, in a dimly lit basement, they still had it. It was on microfiche (remember that, people?). I sat down and perused the notes out of curiousity. Reading off asthma drugs long withdrawn from the market.

And then I came to the nurse's notes.

And my nurse that night had written "Patient won't stop whining."

WTF! You bitch!

Me? Whine?

I didn't whine! I was sick, damn it! And my IV hurt! And the hospital food sucked! And the TV reception could have been better! And you put the urinal where I couldn't reach it! And you kept waking me up for that breathing treatment! And I needed another blanket because you kept my room pretty freaking cold! And you had coffee-breath!

I put the chart away. I was curious. I called the pediatric floor to ask if she still worked there.

She'd retired the month before I started my internship.

You got lucky, lady.

Skool Nerse Time

This is Mrs. Grumpy.

Attention little school twits:

If you're going to fake illness/trauma/death to get out early on the last day before Winter Break, here are some tips for next year (since today's attempts failed).

1. Know where your freaking appendix is. Pointing to the left hip is not going to score points. Moving your finger around and trying to get me to say "warmer" or "colder" will not work. I am not stupid.

2. If you come in weekly claiming to have appendicitis, don't even bother to do it today.

3. After I send you back to class, calling your mother (or, better yet, 911) from your cell phone to complain that you're being mistreated and ignored by the school nurse does not help your cause. There is a reason my office is right across from the Principal's, and my door is always open. Everyone can witness what is going on in here. In fact, you aren't supposed to be using your phone during school hours. Now that you did (and for a bullshit reason) it will be confiscated if you bring it back in January. And I don't care whose greatest hits you have on it.

4. If you don't want me showing your Mom my list of all the times you bring your lazy butt in here for a stomach ache (which I write next to what classes and tests you had at those times) then don't tell her to come talk to me about how I'm not caring for you properly.

5. The "fibulia bone" is NOT in your arm (in fact, it doesn't exist, but I assume you can't spell either). So don't tell me you broke it, and hold your arm. Coming in claiming that your left arm is hurting, and favoring your right arm, doesn't help. Neither does limping when you come in for arm pain.

See you in 2 weeks.

The Return of Wrong Way Wooten

Mr. Compass: "Sorry I'm late. Mapquest told me to take a right on 3rd street to get here."

Dr. Grumpy: "You are supposed to take a right on 3rd street to get here."

Mr. Compass: "Yeah, but I took a left. That's why I was late."

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.

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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."