December 24, 2009. Tis the season

Oh, 2 tomatoes, and some paper plates? No problem. Let me get my car keys.

Crap, Local Grocery is mobbed. Hey, bitch! Don't flip me off! I wasn't even looking at that parking space. Chill.

Merry Christmas, Mr. Salvation Army dude. My only cash is $3, but I'll gladly put it in your kettle.

What a fucking mob scene. Hey! Don't push me! I didn't even want the last shopping cart! I'm just here for some damn tomatoes, lady. Merry Christmas.

Hi, it's me. I have the tomatoes. What brand of paper plates do you want? No, it looks like they're out of those. Okay, I'll get Chinet. Says they're made from recycled paper. Hope it's not toilet paper.

No, Mr. Salvation Army. I gave you my last $3 on the way in. Remember? Merry Christmas.

Hello? No, just leaving. Lettuce? Yeah, hang on. I can go back. Looks like some guy in a Santa hat is yelling at the Salvation Army guy for blocking the door, but security is leading Santa away now. Shit, somebody took my parking space as soon as I pulled out. Let me find another one.

Sorry, Mr. McDonald's manager. I didn't realize this space was for McD's customers only. It's not marked that way. I'll move my car, don't worry. Merry Christmas.

Mr. Salvation Army, it's me again. I had to come back. You have my $3 already.

Lettuce... hey, stockperson, whatever sex you are, where's the lettuce? You only have 3 heads left? Wow. I had no idea there'd be such a rush on iceberg for Christmas. Well, this one looks like it's been dropped the least.

It's a self-checkout. Look, I don't recognize you as one of my Alzheimer's patients, but you obviously are not grasping how to work this thing. So go over to the cashier and check-out the old fashioned way. I think she's one of my dementia patients, so I'm sure you'll have a lot to talk about while you hold up that line.

What the fuck! It's not taking my credit card! All I want is one fucking head of bruised iceberg lettuce!

WhatdoyoumeanthefuckingcreditcardsystemhascrashedbecauseeveryotherlastminuteloserinAmericaistryingtousetheircreditcardrightnow?

How long will that take?

NO! I DON'T HAVE ANY FUCKING CASH! I GAVE MY LAST 3 DOLLARS TO THE FUCKING SALVATION ARMY GUY! IF I HAD ANY CASH DO YOU THINK I'D BE WASTING MY TIME TRYING TO PUT A SINGLE $1.29 HEAD OF LETTUCE ON A FUCKING CREDIT CARD?!!

Well, fine. I'll go over to the ATM across the parking lot. Look at that line and NO, YOU BELL-RINGING ASSHOLE! YOU ALREADY HAVE MY $3! IF I HADN'T PUT IT IN YOUR FUCKING KETTLE I'D HAVE BEEN HOME BY NOW!

This is the line for the ATM? There are 5 freaking ATM's here? Oh, great, the other 4 are all out of cash due to the Christmas rush. Fine, I'll wait.

Hello? No, I'm in line at an ATM. I need to get cash to buy lettuce and... Because I gave it to the Salvation Army guy, that's why! Look, it's taking longer than I thought!

NO, MR. SALVATION ARMY! I just got this $20 out of the ATM after waiting for 15 minutes, because I gave you my last $3 and now the credit card machine is broken, and if you approach me again I'm going to shove that fucking bell up your ass.

YOU SOLD MY FUCKING BRUISED HEAD OF LETTUCE TO SOMEBODY ELSE? ARE THERE ANY LEFT? NO? CALL THE FUCKING MANAGER!!!

Fine I'll take this bag of salad instead, but it better be for the original $1.29. Merry Christmas.

Don't even think about it, Mr. Bell Ringing Salvation Army Guy.

When I got home Mrs. Grumpy told me she'd just found an extra head of lettuce in the refrigerator. She'd forgotten she'd bought one yesterday and put it in the produce drawer.

Merry Christmas to all, and to all a good night.

Healthy Living

Okay, my office is closed today, but I'm working at home, doing some marketing reviews online.

One company had me watch a television commercial in development for a new Parkinson's Disease treatment, which featured patients explaining how the disease interfered with their ability to do things they enjoyed.

One of them, I swear, was a lady explaining how, because of her Parkinson's Disease, she'd had to stop smoking, and showed a "before" clip of her trying to light a cigarette with her hand shaking all over.

Then she went on about how with new drug ParkieMiracle her coordination had improved so that SHE'D BEEN ABLE TO START SMOKING AGAIN, and showed her happily puffing away.

This ad agency really needs to be fired, or find some better examples.

More Gift Ideas

Last one for the year, for you last minute shoppers.

I'll generally ignore a few small holes in my undies, but when they become too far gone I just go to Costco and buy a bunch.

Apparently, though, this idea is too simple for others...

Augh!!!!!!!!

This message was left on the office voicemail over lunch hour:

"Hi. I have a gray pill, with 10 on one side and nothing on the other. I have no idea what it is, but I got it at Medco. It's for my husband and we only have 3 left. Call me right away."

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)