Dear Dr. Dumpster,

I appreciate you sending Mr. Etoh to my practice.

We had an appointment scheduled for him, but after further review of your notes I cancelled it, as I feel seeing him at this time won't be possible.

It was very helpful that you sent his MRI reports, and the EMG findings, and the list of medications he'd tried in the past.

But most helpful was the handwritten note (and I recognize your handwriting) on the last page of the fax, which simply stated "December 14, 2009. Mr. Etoh came to appointment inebriated and punched receptionist. Police notified, patient fired from practice. Told to see a neurologist, given Dr. Grumpy's name."

Anyway, it looks like I'm not currently accepting his insurance, whatever it is (even if it's cash), and have referred him to my former colleagues at Humungous Neurology, Inc.

Wishing you a Merry Christmukah,

Ibee Grumpy, M.D.

Hey! This sausage tastes like... uh, chicken?

More fun at drug rep lunches:


Mr. Pharmastud: "I brought pepperoni and sausage pizzas, I hope you like them. I don't like the other kind myself."

Dr. Grumpy: "What other kind?"

Mr. Pharmastud: "The ones with only veggies. Veterinarian style."

Dr. Grumpy: "You mean vegetarian."

Mr. Pharmastud: "Um, yeah".

More Gift Ideas

What's more exciting than Formula 1, Indy Car, and Nascar racing?

Why elderly-patient-in-a-wheelchair-on-Aricept racing, of course! Rev that wheelchair, squeal those tires, and rocket down the hall to the day room for some serious pottery lessons!

(click to enlarge)

Whatever

Dr. Grumpy: "Who's your regular internist?"

Mrs Belfry: "Dr. Elderly. He specializes in generic patients."

Dr. Grumpy: "Generic patients?"

Mrs: Belfry "You know. Old people."

Dr. Grumpy: "You mean geriatrics?"

Mrs. Belfry: "Whatever. Same thing."

Tuesday Morning, 1:47 a.m.

"Hello, um, we worked together, in 1995, I think you were in residency at the time. Anyway, I hate to bother you, but I really need some Vicodin or something called in, because I have really bad neck pain, and back then I mentioned it to you. I'm not a junkie because I used to have a nursing license and learned all about these drugs, and why you shouldn't abuse them, so if you could please call some Vicodin in to Local Pharmacy I really need it."

This is a yes or no question

Dr. Grumpy: "Did the new medication cause any side effects?"

Mrs. Pain: "No, none at all. But I got a rash from it, and it made me sleepy."

Thank you for sharing

A company I consult for was trying to set up a time for me to review data. The person at their office stopped returning my emails and calls for a week, then emailed me this morning to apologize.

Could he have just said "Sorry, I was out sick"? Of course. Did he. Hell no!

Instead he felt the need to send this:

"Sorry Dr. Grumpy, I haven't been feeling well, and was out of the office. I'm having terrible rectal problems, and am scheduled for an anuscopy tomorrow. I'm not looking forward to it, either."

Hey! This is like a ride!

And what a ride it is.

I'm shocked to look at the calender.

Today is 1 year since my first post.

Now, 365 days and 615 posts later, here I am.

I started writing this just to bitch. I had no idea so many others would enjoy it.

In 1 year I've gone from 1 daily reader (me) and zero blogger followers to 2800 daily readers and 231 Blogger followers.

And all I can say is THANK YOU, to all of you. Your comments and emails and idea/story contributions have made this more fun than I EVER dreamed it would be.

I'll keep writing as long as it's fun and the patients give me reasons too. Which will likely be a long time.

Dr. Grumpy.

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."