Randomness from the road

Driving back and forth on call this weekend I've:

1. Been passed on the highway by a guy riding a motorcycle. Whose head protection consisted of a snorkeling mask- with snorkel attached, flapping in the wind.

2. Seen a guy go down the street, wearing only a baseball hat, mens bikini briefs, and rollerblades, pulled by 4 huge dogs. Like some sort of suburban musher.

3. Passed a pick-up truck with a table & 4 chairs in the back. 3 girls and a guy were sitting in the chairs, reading (with some difficulty in the wind) the newspaper, as if they were at a breakfast table and not going down the freeway.

Did we take our Ritalin today?

Reading another doctor's note in a chart, found this:

"Patient has had multiple admissions for similar episodes, in 2002, 2003, 2004, 2006, and now. Blacks-out when standing-up. History of chest pain. Takes daily aspirin. Also had some sort of surgery in 1999, but doesn't know what. Recently started a new drug for his diabetes. Says the surgery might have been on his stomach. As an outpatient he sees Dr. Jones. Says his father had similar issues. Echocardiogram in 2008 showed normal ejection fraction. Retired accountant. Chest pain is gone now, but had some yesterday. All labs normal, but they show anemia and liver issues. Spent yesterday working in yard before the black-out. Felt clammy. Mother died of breast cancer in 1965. Sister living. Says he has an apppointment with a cardiologist as outpatient coming up. Moved here from Michigan. Had a head CT this morning, but hasn't been dictated. Currently is asymptomatic. Should probably consult neurology."

I agree with the last part. But the patient isn't the one who needs me.

On call

Just keep swimming.
Just keep swimming.
Just keep swimming.

My readers write

Reader Emily writes:


I was at my OB/GYN 's office this morning, in the waiting room, when I overheard the following conversation. I immediately thought of you.

Patient: "I think I have an appointment today but I'm not sure. You should probably look it up."

Receptionist: "Yes, ma'am, you have an appointment. Please sign in."

Patient: "What am I here for? Because I've been here before and I'm not sure why I'm back."

Receptionist: "I just have you down for a follow up."

Patient: "Ok. Thanks."


It's hard to believe these things happen in real life.

Yes, Emily, it is. And I'm glad to know it happens to other doctors, too. Thank you!

Music to be Grumpy by

For unknown reasons, several of you have written in wanting to know what I listen to. So here we go.

I have a pretty wide taste in music, with my iTunes having roughly 5000 songs on it, about 1/3 of which are classical pieces, and the rest are more contemporary. And I always play it on random shuffle, so any given day, while working at my desk, I hear a wide variety of stuff.

I have a lot of the same stuff you likely have, a mixture of top hits, "classic rock" (whatever that is anymore), other popular stuff, and some offbeat songs,. Rather then naming everything, I thought I'd list some of the lesser known stuff I listen to.

Here they are, with my impressions, in no particular order.

1. The Fabulous Poodles. This mostly forgotten group had only 1 hit in the U.S. ("Mirror Star", in the late 70's), but they were AWESOME. They did some of the most eclectic stuff ever, blending violins with modern rock instruments, and songs that span a remarkable gamut of styles and odd topics (suicide, dessert, anorexia, artificial body parts, vampires, etc.). A sampler collection called "His Masters Choice" is still out there on CD. It doesn't have all their good stuff on it, but it's still awesome.

2. Spinal Tap. Created for the excellent mid-80's movie of the same name, this group has endured, to the extent that some people now don't realize the whole thing started as a joke. Their collection of intentionally badly written lyrics and tasteless music somehow remains quite entertaining. I was listening to Spinal Tap long before I ever dreamed I'd be doing spinal taps for a living.

3. Shriekback. Okay, I only have 1 song by them ("Nemesis") but let's face it- how many other dance numbers feature the science word "parthenogenesis" in the chorus?

4. Sisters of Mercy. Again, I only have 1 song by them ("This Corrosion") but this dance number is remarkable for it's catchy beat, 10 minute length, and absolutely senseless collection of lyrics. The random phrases sound like something written by a guy with left-sided brain damage (which, for all I know, they were).

5. Tom Lehrer. American humor music is a triad of Tom Lehrer, Allan Sherman, and Weird Al Yankovic. All are good, but to me Lehrer is exceptional for his style of writing, and blending it with his advanced knowledge of mathematics and science. Allan Sherman is mostly forgotten today (he died in 1973), but his influence on all who've come since is unmistakable.

6. Maggie Estep. I may be the only person on Earth who bought her CD "No More Mr. Nice Girl", but it's awesome. More of a collection of poems read to music then true singing. But how can you NOT like a song featuring lyrics like "Fuck me and take out the garbage, feed the cat, and fuck me"? And her monologue "Bad Day at the Beauty Salon" is unforgettable.

7. Al Stewart. Remarkable stuff. Known primarily for his 1970's hit "Year of the Cat" and a few others, he remains an excellent songwriter and performer, who does fascinating work based on historical themes. His live album "Rhymes in Rooms" of just him and acoustic guitars, is one of my favorites. Ever.

8. Saturday Morning's Greatest Hits. What a great idea. Get a bunch of 1990's bands together, and have them re-record the theme songs from the 1970's cartoons I grew up listening to. Liz Phair's version of The Banana Splits" theme is awesome, and the album continues strong all the way through. Underdog. Hong-Kong Phooey. Speed Racer. Scooby Doo. Fat Albert. The Groovy Ghoulies, and many more. A related album of remade "Schoolhouse Rock" songs was okay, but not as good as the cartoon themes.

9. Gary Numan. Mostly remembered for his only U.S. hit "Cars", he actually had 3 interesting albums in the 1970's (Replicas, The Pleasure Principle, and Telekon) which were pioneering works in the use of synthesizers.

10. The Refreshments. Their album "Fizzy Fuzzy Big and Buzzy" is excellent. How many relationship songs have the chorus "I can't sleep, 'cause she snores like a chainsaw!"?

11. Northern Exposure. One of the few TV shows which I really, really enjoyed. The music CD contains an extended version of the theme song (which my mother calls "The Moose Dance") and a selection of songs played in the background during the show. They vary from Nat King Cole to Magazine 60 to Lynyrd Skynyrd.

On an unrelated note, I think this was one of the best TV series, ever. Did anyone else out there think it should have ended with the episode "The Quest", which featured Joel and Maggie looking for the "Jeweled City of the North"? To me, that one hit the right notes to end the show on, but instead they dragged it out for a few more episodes.

12. Sparks. Were these guys great, or what? Their greatest hits set contains their only popular song ("Cool Places"), a delightfully generic dance number called "Music That You Can Dance To", and even a song about sperm ("Tryouts for the Human Race").

13. The Dead Milkmen. These guys mastered the art of the quick song, with some of their stuff being less than a minute. The rambling musical monologue "Stewart" begins with the line "I like you, Stewart, you're not like the other people, here, at the trailer park" and goes on to discuss an accidental decapitation at an amusement park and paranoia about the government being in cahoots with homosexual martians to poison the soil.

14. Cast. These guys never really took off in the U.S., but I for one thought they were great. Their album "All Change" is a neat collection of songs that blends a 1960's retro sound with more modern stuff.

15. The Disneyland Soundtrack. Yeah, I know. I guess this is a hazard of going to the parks as a kid, and now having gone with my kids. It's simply a collection of music from the rides (yes, including the dreaded Small World) but is oddly entertaining. And certainly brings back memories. If you're driving when they hit the launching point in "California Screaming", it's hard to resist mashing the gas pedal and pretending you're on the ride.


Not an inclusive list, but for the inquiring minds who wanted to know, now you know.

Another fine patient quote

"All foods make me sick, but only if I eat them on an empty stomach. So I usually take a snack before meals, so I don't get sick."

Attention well-meaning sister!

I know you're concerned about your sister, Kris. I mean, you don't have kids of your own, and live 1000 miles away, but you do talk to her on the phone regularly.

I guess you found out I treat her for headaches. I can't really talk to you directly, due to privacy issues, so please accept this as my answer:

Please DO NOT leave a message on my office voicemail saying that I need to work her up urgently for a brain tumor (you read about them in Reader's Digest) because she's been more forgetful and disorganized since having triplets 3 months ago.

It's not like you've been out here to visit in that time, either.

If you have even one kid someday, you'll understand. And when you do, multiply what it does to you by 3, then call me and Kris back to apologize.

Thank you.

History Fail

Mr. Hiztory: "I changed insurance because I'm afraid of Obama's plan."

Dr. Grumpy: "How long have have you had this policy?"

Mr. Hiztory: "Since 2006."

Dr. Grumpy: "He wasn't President in 2006."

Mr. Hiztory: "What does that have to do with it?"

Skool Nerse Time

This is Mrs. Grumpy.

I had a surprisingly quiet day in my office, with only a handful of visitors. So I decided to clean out one of the filing cabinets.

This is not, mind you, a cabinet I've ever put anything in. It's been in the corner of my office since I started this job. According to the school secretary it's been there as long as she can remember. And she's been here a LONG time. And the school dates back around 40 years.

So, the last time anyone actually looked in the cabinet remains a mystery. Basically, I was opening a time capsule.

A lot of it was dusty old records of kids who likely have grandkids by now. But in one drawer I found a pile of coloring books to give to kids, about child safety.

They were from 1972. And have likely been in the drawer since then.

So let's look at a few pages, shall we?

This page is the introduction. Isn't it amazing what you could get away with in 1972? These anglicized, stereotyped Native Americans likely wouldn't make it past a political correctness committee today.





Now this page is great. Yes, kids, that is a PHONE. When Dr. Grumpy and I were young you had to DIAL phone numbers (I know, I'm dating us here). NOT press buttons. NOT hit speed-dial. NOT say "call Buffy" to the phone. There was that BIG round thing on the front, and you had to dial in the digits ALL BY YOURSELF. So next time you hear someone say "dial a number" or "dial tone", you know where the expression came from. And yes, clowns really were that creepy back then. And, for the most part, still are.





This next page, however, is my favorite. In 1972 it was apparently considered normal, and safe, to leave GUNS AND AMMO lying unattended around the house, provided your kids had been told not to touch them. After all, if you tell kids not to do something, they ALWAYS listen and know better then to actually do it. Right?






I hope you've enjoyed this trip down memory lane. If you have young kids, and you're not at home right now, please dial them up to remind them not to play with the guns or let clowns in the house (if clowns are already in the house, then it's better that your kids have access to guns).

Yo ho and a bottle o' pee!

Dr. Pissy or I occasionally order a urine test. So we have a patient bathroom with a bunch of urine sample cups & lids, and a Sharpie ink marker. Patients are told to write their name on a cup, pee in it, and put it in our lab.

So yesterday afternoon a lady walked out of the bathroom. Annie and I were talking in the hall, and she flagged us down.

"Um, excuse me, I have to give a urine specimen, and want to know how much you need. There are, like, 20 cups on the counter in there, and I don't think I can fill them all up."

What the hell?

Dr. Grumpy: "Any illnesses run in your family?"

Mr. Fallz: "Yes. My brother is 3 years older than me, and my sister is 7 years older than me. So I guess both my siblings are older than me. My parents are also older than me."

Not a good sign

It's never a good sign (at least in a neurology practice) when this shows up on a new patient form:

(click to enlarge)

Attention Drug Reps!

When you tell me that your product causes less constipation than your competitor, I'm happy to look at your colorful brochure and nod.

I do not need any kind of personal endorsement.

Specifically, I really don't care to hear about how YOU got horrible constipation from the other drug, and all the methods you had to use to finally be able to relieve yourself.

Especially when you brought us a lunch of tuna sandwiches on brown bread.

Although I do think it's funny that your company's health insurance won't cover its own drugs.

Have a nice day.

Society pages

Harder to get invited to than a Presidential Inaugural Ball...

Fancier than an upper-crust party on the Queen Mary 2...

Wilder than a post-Oscar Hollywood bash...

Yes, this past Saturday was the annual Wingnut Elementary School Daddy-Daughter Dance.

As usual, the attendees were an A-list from Wingnut School grades 1-3, accompanied by their (considerably older) dates. This annual event, which is often mistaken for an FLDS mass-wedding ceremony, is the social event of the season for the young ladies.

The evening begins for most at an elaborate banquet, with swanky restaurants chosen by the gals. Bistros are selected for atmosphere, food, and (most importantly) the current month's Happy Meal offerings.

Marie Grumpy this year chose the elegance of a Denny's, and, when handed a Kid's Menu, glared at the server with obvious disdain and asked for "the grown up menu, the one with salmon on it." Rumor has it that her escort had grilled cheese.

Dresses in all colors of the rainbow were popular among the debutantes. Marie Grumpy was resplendent in a black dress, brown socks, and knee-high leather boots that she found in the costume closet (and was quite insistent on wearing). She completed her outfit with a shark-tooth necklace she'd purchased at SeaWorld last Summer.

Upon arrival at the event guests were greeted by a sumptuous hors d'oeuvre buffet of cookies and juice boxes. They were then ushered into the dance hall, which had been cleverly decorated to look like a grade school gym, with basketball hoops hanging from the ceiling and bleachers along the walls.

And so the festivities began. The floor was covered with balloons, whose popping (as they were stomped upon) added to the loud music and disco light display. One participant described the delightful spectacle as "migraine-inducing". It also led several of the young ladies to break decorum in a light-hearted balloon fight, which escalated to injuries serious enough to require a small band-aid to cover a boo-boo in one victim.

One unidentified father (but we all know who you are, Mike) graced the scene by wearing a HOT PINK TUXEDO to the event. This outfit certainly made him stand out from the rest of the crowd, especially when he danced on top of a table during "YMCA". His young escort was last seen by the ladies room, with a paper bag over her head.

Another injury occurred when a father was assaulted near the cookie table. He'd apparently never seen the Animal Planet show about "never get between a mother bear and her cubs", and didn't realize that it was even more dangerous to get between Marie Grumpy and the chocolate chip cookies.

One father spotted a neurologist, and cornered him to ask about groin pain. He had to yell to be heard over the music, and learned (the hard way) that if the music stops, and you keep yelling, then EVERYONE can hear about your medical concerns.

Another lovely princess had to leave early, after she vomited all over the dance floor. Her escort brazenly told the crowd, "she's been barfing all day, but I figured she'd stop after we got here." A local neurologist who witnessed the event commented that "although it's really not my field, generally a handful of cookies and a box of juice isn't a great treatment for projectile vomiting." We can only hope other parents will heed that advice next year.

The after-party was held at Local Ice Cream Parlor, where several interesting combinations were tried. Marie Grumpy had cotton-candy ice cream with Kit-Kats, while a young friend of hers had chocolate fudge with Gummi bears.

All are looking forward to next years ball, except for the guy in a pink tuxedo, whose man-card has been revoked.