Things that make me grumpy

Ms. Crappystaff: "Dr. Imed's office."

Dr. Grumpy: "Hi, it's Dr. Grumpy. You guys referred Mrs. Brain to me for an abnormal MRI, and I don't have the report. She's here now. Can you please fax that over, ASAP?"

Ms. Crappystaff: "Hang on... Sorry, the doctor just went into a room with a patient, and doesn't like to be disturbed. I can have him call you back later."

Dr. Grumpy: "I don't need to talk to him. I just want you to fax over the MRI report."

Ms. Crappystaff: "I'm not comfortable doing that. I don't know what the report means."

Dr. Grumpy: "I'm not asking you to know what it means. All you have to do is fax it to me."

Ms. Crappystaff: "Don't patronize me. I don't even know who you are."

Dr. Grumpy: "I'm Dr. Grumpy. You faxed over an insurance authorization on this patient an hour ago. I just need the MRI report, so I know what to tell her."

Ms. Crappystaff: "I told you, I'll have Dr. Imed call you to discuss this."

Dr. Grumpy: "The patient is here now. I just need the MRI report. Please fax it over. It's why you guys sent her to me."

Ms. Crappystaff: "You obviously don't understand the importance of patient privacy."

And she hung up.

Continuing Medical Education

Doctors, to keep our certifications, are required to do 20-30 hours of continuing education per year. Some docs go to conferences. Some do them online. Others do them in writing.

The format is the same. There's always an article, followed by a quiz you have to pass (to prove you really read it), then an evaluation form with some pointless questions (Did you like this CME? How will you change your practice because of it? Was it free of commercial bias? What other topics would you like to see CME on? Are you bored shitless yet?).

Anyway, yesterday I was doing a CME on new MRI techniques in Multiple Sclerosis. While filling out the evaluation form I came across this question.

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It is entirely unrelated to the CME topic. I can only assume it was put in there to see if I was still paying attention (yes, I was. And I do wash my hands at least twice a week).

Sounds good, Frank

Frank had to write a report about dogs for school, and asked me to proofread it for him. I discovered this:

"Some dogs have very good eyesight. Because of this, they can hear in the dark."

Sunday reading

Okay, while relaxing outside and catching up on my journal reading today, I learned the following ground-breaking medical news:

1. Sleep deprivation can impair your thinking, while getting some rest can improve things again (Neurology Reviews, April, 2010).

2. Patients who get two blood thinning drugs have a higher risk of bleeding than patients who get only one (Archives of Neurology, March 8, 2010).

3. People who smoke have an increased risk of stroke and TIA (paper presented at the 2010 International Stroke Conference).

Sunday morning, 7:57 a.m.

Dr. Grumpy: "Dr. Grumpy, returning a page."

Mr. Husband: "Yeah, you see my wife for Alzheimer's disease, and she had a seizure 2 weeks ago."

Dr. Grumpy: "Uh huh."

Mr. Husband: "Well, ya know, I was just thinking, she was maybe just a bit more alert for a few days after the seizure, not a lot, but maybe a little. Can I bring her in to your office and you can make her have another one?"

Scintillating conversation

Tonight Mrs. Grumpy and I were sitting on a bench at a local park, listening to a band. A group of teenagers went by, and we heard this discussion:


Dude A: "So like, you go to North High?"

Dude B: "Yeah."

Dude A: "I go to Central. What's it like at North?"

Dude B: "We have, like, students and teachers and stuff. Classes, too."

Dude A: "That's cool."

Need nutrition? Got fungus? No problem!

I'd like to thank my reader Boris for submitting this oddity.

On-call food

You guys have heard me bitch about the miserable sleep-deprived, food-deprived, caffeine-deprived condition called "being on-call" that us docs live through.

I describe things best with words. My esteemed colleague Fizzy, however, draws pictures. And for those of you who, after reading my blog, still don't understand the state of desperate insanity that being on-call causes, I present Fizzy's recent, very accurate, pictorial description.

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Can't argue with that

Mr. Klumsy: "I hurt my back when I fell down."

Dr. Grumpy: "What made you fall down?"

Mr. Klumsy: "I don't know. Gravity, I guess."

Attention patients!

I have nothing against dogs. I have 3 of them. I am a dog person.

And I really don't mind if you bring a small dog to the hospital to comfort a sick person.

But if you do, and a neurologist comes in the room to round, please try to restrain Li'l Cujo when he lunges across the room, barking and growling, to take a piece out of my ankle.

Fortunately, it stopped bleeding quickly, and a band-aid covered it.

Please fax your "harmless little cuddly-wuddly's" rabies shot records to my office today.

Mary's Desk, April 29, 2010

"No, ma'am, your Local Grocery Shopper's Club card is NOT an acceptable form of paying your doctor visit co-pay, nor does it get you any sort of discount here."

Mind reading

Dr. Grumpy: "Do you get nauseous when you have a headache?"

Mr. Apap: "I don't know. You're the professional here."

Evolution in reverse

Cell phones, and our love/hate relationship with them, are a popular blog topic. Rude patients/customers/doctors who conduct routine calls solely to inconvenience those around them are a popular gripe topic. But that aspect of the damn things isn't what I'm bitching about today.


Millions of years have gone into humans figuring out how to survive danger and carry on the species. But modern technology has turned the clock backwards on this.

In the 1980's video cameras become cheap and widely available. Suddenly, instead of frantically running away from tornadoes, every bozo suddenly felt the need to stop and shoot movies of them, hoping to get 5 minutes of fame on the local news. I'm not talking about trained stormchasers here. These were always local yokels in a car, with their terrified kids screaming in the background, who pulled over to get some once-in-a-lifetime shots of an oncoming funnel cloud as it destroys their house. Nice work.

Similar videos popped up with every earthquake. "Hey! The house is shaking! I'm gonna film this for a minute, then check on the kids!"

But the phenomenon has gotten worse with the invention of the cell phone camera.

Besides the obvious dangers of distracted driving, now every disaster is accompanied by people frantically whipping out cell phones. Some take pictures of it. Others feel it's a great time to call friends. "Yeah, the building is on fire. You wouldn't believe it. I should probably leave soon. How was the poker game last night?"

It's obvious to anyone that you can run faster if you swing BOTH arms. So if you're running for your life, it would seem counter-intuitive to swing only one. Right? Now let's look at this screen shot from CNN earlier this year, of people fleeing aftershocks of the Chilean earthquake.




Yup. Both of them are running, and talking into cell phones (not to mention the person who stopped to take their picture).

"Yeah, It's a bad aftershock. I hope it doesn't knock over the cell phone transmitter antenna. If it does, I don't know how I'll be able to call Marta to tell her about the aftershocks."

Imagine you're a prehistoric man in a cave. Suddenly a saber-toothed tiger walks in. Your reaction, sensibly, is going to be either to run like hell or find a club. Somewhere along the line our intelligence allowed us to survive these encounters.

But nowadays people are different (I'd like to thank my reader, Lee, for sending this):


'A bobcat walks into a bar . . .'
March 27, 2009, 6:55 p.m.
The Arizona Republic

COTTONWOOD, Arizona- A bobcat walked into a roadside bar in Cottonwood.

What happened next was not a joke but "pandemonium," two or three minutes of chivalry, cell phone cameras and people jumping on top of pool tables to get out of the way. When it was over, two people were scratched and bleeding, and the rabid bobcat was killed by police in a parking lot on Main Street.

At about 11:40, three people walked out of the Chaparral, a neighborhood bar with signs for Schlitz, Budweiser and Coors over the entrance. Tuesday is free-pool night.

"I said good night," said bartender Scott Hughes, 41. "Next thing I know, they are running back in, followed by a bobcat. One jumped on the pool table, and two more jumped onto the bar."

The bobcat chased two people around a pool table. That's when people took out their cell-phone cameras to get a picture.

People talk about the degradation of morals and the end of society. Hell, we've survived a lot, and I'm not worried about political hysteria from either side.

But sheer stupidity is another issue.

Wednesday night, 6:49 p.m.

"Hi, this is Hank Bozo. I just found an old message on my cell phone reminding me to come to my appointment with Dr. Grumpy on March 19. Can someone please call me back and let me know if I showed up for it, and if I did, what we decided to do. If I didn't show up for it, I want to make another appointment. Thank you."