Annie's Desk, May 5, 2010

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

Mr. Derm: "Yeah, Dr. Grumpy prescribed Lamictal for me last week, and now I've got a bad rash all over."

Annie: "Yeah, it can do that... Let me go ask him." (puts patient on hold, grabs me in hallway for advice, goes back to phone). "Yeah, he says you need to stop it."

Mr. Derm: "I haven't started it yet. I forgot to pick it up at the pharmacy."

Does he take your insurance?

Dr. Grumpy: "Have you ever seen a doctor for these symptoms?"

Mr. Aura: "Sort of, I talked to a guy about them."

Dr. Grumpy: "Is he a doctor?"

Mr. Aura: "No, he fixes cars."

Medical Research

Okay, I've made fun of medical research studies here and there for bizarre, useless, redundant findings, and redundant findings.

But a study published yesterday in the respected journal Pediatrics has stunned even me.

This study found that (shocker!) overweight kids are ALMOST TWICE AS LIKELY to get teased/bullied than kids who are of average weight.

Really. They did a study to find this out.

I'm sure someone out there is going to claim I'm supporting bullying. Or making fun of the overweight. But my ONLY point here is this: does this conclusion actually surprise anyone? Was this research necessary?

Disclaimer: I was NOT a bully. I was the bully-ee. So don't look at me as someone defending the playground thug. I hated them.

These researchers, using somebody's money, actually studied 821 kids in 3 elementary school grades in multiple schools across the U.S. It didn't say how long this groundbreaking research took. I can only assume that we've now learned everything there is to possibly learn in pediatrics, and so research is expanding into this sort of stuff.

Let's face it. ANYONE who grew up in the American school system (and likely any school system on Earth, after all, Augustus Gloop was German), could have told them this. Any KID in school today could have told them this. Any PERSON who watches a playground for 10 minutes could have told them this (although more likely would be arrested for being a stranger watching a playground and taking notes).

But, to prove my hypotheses, I did my own research, using 3 renowned scientists:

Marie Grumpy is known for her veterinary research in improving the eyesight of dogs.

Craig Grumpy is known for techniques to convert pharmaceutical models into aquatic habitats.

Frank Grumpy, at an early age, did research into how many cardboard boxes full of adhesive band-aids can be flushed down a toilet at once (his submission to American Plunger Journal was rejected because he didn't know the alphabet at the time).

So I showed each subject 2 pictures, which I found on Google images. One showed a thin kid, and the other a not-so-thin kid. Each of my 3 associates was asked which kid Jake Rottweiler (their school bully) was more likely to pick on.

All 3, in separate questioning, and with no access to their colleagues' answers, picked the not-so-thin kid.

My project took all of 15 minutes, and cost me a $3.49 half-gallon of Cookie-Dough-Explosion ice cream (to pay my research subjects for their time).

Take that, Pediatric journal writers.

New word of the day

Dr. Grumpy: "Did your mother have migraines?"

Mrs. Neologism: "No, my family doesn't have any hereditarialistic diseases."

Biting my tongue

"This all started at the local golf tournament. I'd forgotten my own set of clubs, and so when we got to the tee I had to use my husband's, and was angry that I'd left mine at home. Anyway, with everyone watching, I yanked out my husband's club and began waving it around, just as a joke. I think I hurt my hand because of the way I was holding it."

Convalescense

Yesterday, you may have noticed my posts ended early. This is because Dr. Grumpy was temporarily rendered into a barfing idiot by the evil pukingfeverachingholyfuckIfeellikeshit virus.

It started in mid-morning. I tried to stay at work, but just couldn't.

I had Mary reschedule the patients (which I HATE doing). I could barely think, or stay out of the bathroom (if you're part of the night staff that cleans my office, I'm really sorry I did that in my trash can). I had to get home.

Fortunately I live near my office. The kids were in school. So I thought I'd be able to rest and be sick alone for the day.

Fat chance.

I opened the door and...

Snowball: The people! The Master is home! He's home early! Ohboyohboyohboy!!!

Cooper: I am so happy! The Master! I must bring him something to welcome him! Here are Craig's underwear with skidmarks for you, Master! I found them in the laundry pile!

Blackdog: Stay away from him, you bozos. He smells bad.

Cooper: No! It's him! We must bounce in front of him to have him pet us! He loves it!

Snowball: Ohboyohboyohboy!

I grabbed a big tupperware bowl and collapsed onto my bed...

Blackdog: I'm going to stay in the hall. He doesn't look right.

Snowball: He's lying down! He's wants to play! He wants me to jump on the bed and bounce on his stomach!

Cooper: Play! Play! Play!

Snowball: Look! He's filling the plastic bowl up with semi-digested food!

Cooper: Wow! Just for us! I love the Master!

Blackdog: I wouldn't touch that. It smells like Diet Coke and Corn Flakes.

I doze off...

Cooper: The Master doesn't look happy.

Blackdog: No shit. Leave him alone.

Snowball: No! We need to cheer him up!

Cooper: I know! We must bring him gifts to make him happy! Come help me knock over the laundry basket full of wonderful-smelling sweaty clothes!

Snowball: Great idea!

Cooper: See! Look at them all over the floor! He will be so happy! Now let's bring all of them and put them next to the bed for him to see!

Snowball: Hey! A tennis ball! I'll bring that, too!

Cooper: Yes! I'll move the clothes and you bring more tennis balls!

Blackdog: Dipshits.

I woke up, desperately needing to barf. I got up to run to the bathroom...

Cooper: The Master is awake! He is jumping out of bed!

Snowball: Yes. He is running... and tripped over the big pile of smelly clothes!

Cooper: Look! He's lying on the floor now! He must want to play!

Blackdog: I don't think so.

Snowball: I'm going to jump on his back! Ohboyohboyohboy!

Cooper: He's running to the bathroom again! I'll jump in front of him to play!

Exhausted, I somehow made it back to the bed and fell asleep again...

Blackdog: Alert! There is a man at the mailbox! We must let the Master know!

Cooper: Yes! Make noise! Everyone! We must warn him!

Snowball: Yes! Now! Lots of loud noise! I'll jump up on the bed next to him to bark, to make sure he hears me!


I'm SO glad to feel better, so I can be back at the office today. It's comparatively relaxing.

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.

(click to enlarge)





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.

(click to enlarge)