Drug Ads

Does this lady look happy, or what?

She was on the cover of an ad brochure one of my drug reps dropped off. It's for a pill used for excessive daytime sleepiness.

What I think is funny, though, is that the pictures on the left (the "before drug" shots) are supposed to be abnormal.

Lets start at the top:

1. Lady dozing off at work. Who doesn't do that here and there? Hell, I slept through most of my pathology class in medical school. To this day I'm conditioned to automatically nod off when I hear the word "amyloid". And it's not even like she has a can of the sacred waters next to her.

2. Lady finding ironing boring and tiresome. As if anyone froths at the bit and has an adrenaline surge at the thought of finally getting to that mountain of wrinkled clothes.

3. This one is my favorite. The lady has fallen asleep while her boyfriend/husband is watching sports. Mrs. Grumpy is the sports person at out house, but I know plenty of women who consider dozing off in these situations to be perfectly normal. Let's face it- I'm pretty sure he's not watching figure skating.

Personally, if I see anyone who looks like the lady on the right at work or doing housework, I think they need their Lithium dose lowered.

Huh?

Mr. Referral: "My internist wants me to see an endocardaphrologist. What do they do?"

Dr. Grumpy: "I have no idea."

Let me repeat the question

Miss Diet: "I don't eat beef."

Dr. Grumpy: "Are you a vegetarian?"

Miss Diet: "No, I couldn't do that. I'm allergic to dogs and cats."

The family next door

The Goodwin family. From left to right: William, Frederick, Charles, Harold, Lillian, Augusta, Jessie. The baby, Sidney, is not in this picture.


Even through the old black and white, they could be any family you live near. They look like nice people. Clothing styles have changed, but they're the same people we are now.

You can see them getting ready for this family portrait, which likely wasn't cheap. Putting on their nicest clothes, trying to get their hair just right. Harold and Jessie each with a trace of a smile. Maybe they'd shared some sibling silliness just before the picture was snapped, and were told to be knock it off and look at the camera.

We still take family pictures. To freeze those memories of childhood and family that we all hold dear.

Mr. Goodwin, at age 40, was a highly trained electrical engineer. He was having trouble finding steady work in Fulham, England, that would allow him to support his family.

But through his brother in America he heard of a new power plant under construction, in Niagara Falls, New York, that was looking for men with his training. So in hopes of finding a better life, the family sold their modest house, packed up, and booked passage across the Atlantic. They didn't have a lot of money, so had to settle for 3rd class passage.

The food and accommodations in 3rd class, while not great, were certainly adequate. The only potential drawback was that, in the unlikely chance something went wrong, you wouldn't have as easy access to the lifeboats as the wealthier 1st and 2nd class passengers did.

And for that reason, 98 years ago tonight, the entire Goodwin family died on the Titanic.


On a side note, the body of a small boy was found floating in the Atlantic 3 days after the wreck. He was buried in Fairview Cemetary in Halifax, with a monument paid for by the sailors who'd pulled him out of the water. He was listed as an unknown child victim of the Titanic. In 2007 DNA testing confirmed he was indeed the youngest Goodwin, Sidney.

Mary's Desk, April 13, 2010

Mary: "Dr. Grumpy's office, this is Mary."

Mr. Biz: "Yeah, I have an appointment at 3:00 today, and my boss called an emergency meeting for the same time."

Mary: "Okay, do you need to reschedule?"

Mr. Biz: "No. Do you have WiFi?"

Mary: "Um, no, why?"

Mr. Biz: "Because I want to attend the meeting online during my doctor appointment. It's very important."

Mary: "I can reschedule you to tomorrow..."

Mr. Biz: "Wait a minute. You mean to tell me your office doesn't have free WiFi service? What do people do while they're waiting for the doctor?"

Mary: "He's usually pretty prompt, but we have magazines and..."

Mr. Biz: "How can you NOT have WiFi for patients? Just cancel my appointment, I'm going to find someone else."

Overheard at the Grumpy house computer desk

Frank: "Don't click on that button."

Craig: "Why not?"

Frank: "You know."

Craig: "I don't know."

Frank: "It will erase your file."

Craig: "How do you know?"

Frank: "I don't know."

Craig: "You don't know?"

Frank: "I know that you don't know."

Craig: "You don't know what I know because you don't know!"

Frank: "You don't know that!"

Craig: "I know!"

Monday non-sequitur

Dr. Grumpy: "Do you have any back pain?"

Mr. Huh: "No. I'm from Oregon."

Saturday night, on call

I'm sitting down to dinner with my family. My cell phone rings. It's the ER. A patient has just had a stroke, and is a candidate for the "clotbuster" drug, TPA. The drug MUST be given within 3 hours of symptoms onset. It's a serious emergency.

I leave my plate on the table, yell goodbye to the family as I run out the door. I race down the road, and onto the freeway.

I get to the hospital. I pull into one of the special "doctor emergency" slots by the ER entrance. I wave to Willy, the security guy who's been sitting there watching the lot for the last 40 years (he's rumored to be the last surviving veteran of the Spanish-American War of 1898).

I run in. I meet with the family as the patient is being wheeled to CT. He comes back. I look at the CT and call the radiologist. I examine the patient and go over the checklist for TPA, and explain the risks and benefits to them.

The family and patient are willing to throw the dice. The volatile drug is given as we watch. I re-examine him every few minutes. We get a bed in the ICU, and the patient is wheeled off. I write further orders and make phone calls to an internist and cardiologist.

Only time will tell.

And I walk out to my car, hoping to get home before the kids are asleep, and to have some dinner.

(click to enlarge)

Stupid toy of the year award

While I was on call today, Mrs. Grumpy took the kids to Humungous House O'Toys. Because the kids had some gift cards they were dying to use.

So what did all 3 of them buy? Out of all the cool stuff at Humungous Toys? Video games? Some awesome electronic flame-throwing robot dinosaur? A really cool Lego set?

Nope. They each wanted a "Perfect Petzzz".

For those of you unfamiliar with this remarkable use of technology, it looks like a sleeping dog or cat. And all it does is "breathe". The abdomen repeatedly deflects in and out by a 1/4 inch to give this amazing impression.

Let's watch!





Impressive, huh? Exciting beyond words, right? What else does it do, you ask?

THAT'S ALL.

It's fixed in that position. The limbs don't move. The eye's don't open. And, under the fake fur, it's hard as a rock. Seriously. You can hammer nails with it.

It looks like it's breathing, but when you pick it up your first impression is that it's in rigor mortis.

Visually, it's cute for all of 5 seconds. And when you find out that the pseudo-breathing is all it does (until the battery runs out) you're absolutely shocked to find your kids got suckered into paying $29.95 for this thing.

And I'm not gonna criticize it anymore, because I can't. Somebody is getting rich off this stupid idea, and I'm on call trying to make a buck. They're obviously WAY ahead of me in laughing all the way to the bank.

Difficult Case

Okay, all you armchair neurologists, I'm on call this weekend, and it's time for you to help me with DR. GRUMPY'S CHALLENGING PATIENT.

Here's the story:

Mrs. Smith was mugged outside Local Mall yesterday, in an event witnessed by several bystanders. Mr. Scumbag hit her over the head with a crowbar (she'll be fine, don't worry) knocking her out, and grabbing her purse (he's already been caught).

So she was admitted to Grumpy Hospital. And the admitting internist wrote in the chart:

"Neurology consult with Dr. Grumpy, to determine why patient lost conciousness."

This one has me stumped, so if any of you want to chip in ideas to help, I'd appreciate it.

Is she a cat?

I'm on call, and reading another doctor's dictation:

"Family history: depression. The patient's mother committed suicide several times."

It's a guy thing

Memories of patients past...

I don't remember his name anymore. He'd had a massive stroke. Unable to speak. Came in completely comatose. He was in his late 70's.

He was there for a few days. Not a drop of sedation was given. He didn't wake up at all.

On day 2 of his stay, while the family was trying to make a decision, something went wrong with his foley (bladder) catheter. So the nurse had to change it. I was in the room looking at the chart when they started to pull it out.

He yelled, quite clearly, "SHIT!!! MY DICK!!!"

The nurse stopped. He was again completely comatose. I did every trick in the book to try and get him to speak again. Nothing worked. The nurse pulled out the foley, and put a new one in. No repeat performance.

He was there 3 more days before he died. He never said anything else. Every attempt by me and the nurses to try and find conciousness again failed.

To this day I have no idea how he did it. The MRI was awful looking. I can only assume it's some primordial part of the Y chromosome. No matter how badly damaged the upstairs is, you're still touchy about the downstairs.

My 10:00

Showed up 10 minutes late.

Left his insurance card and wallet at his girlfriend's.

Forgot to bring in his MRI reports ("Oh, yeah, I think they're in a box under my bed.")

Had to call his mother to ask what medications he takes.

Forgot to stop at his regular doctor's office to pick up his insurance authorization.

And is wearing a T-shirt that says "I believe in personal responsibility"

Early Morning ICU Rounds

Attention guys:

Having a stomach tattoo that says "SUCK DIS, BITCH!" with an arrow pointing downwards WILL NOT endear you to the ICU nurses!