Math fail

I'm doing an online medical research survey this morning. It began with this message:

"The study consists of 3 sections, each of which is 15 minutes in length. The study will therefore take 1 hour to complete."

Dear BCBS insurance company,

Thank you for tying up my fax machine by sending me 27 consecutive copies of this page, with ABSOLUTELY NO OTHER RELEVANT INFORMATION WHATSOEVER!!!

(click to enlarge)




I'm just SO glad to know that my premiums, and our dwindling natural resources, are being put to such good use by you guys.

Thank you.

More priorities

Dr. Grumpy: "So how did this all start?"

Mrs. Trayler: "Well, on Sunday, I was doing some cleaning, and suddenly I couldn't move my right arm, and my daughter said my speech was slurred. So we went to Local Hospital."

Dr. Grumpy: "Hang on..." (logs into the Local Hospital records) "That's weird, the hospital has no record of you being treated there. Are you sure you went to this hospital?"

Mrs. Trayler: "Yeah, but I didn't stay. The lobby was full, and I was worried I'd have to wait, so I left."

Dr. Grumpy: "You left the hospital with a stroke?!!!"

Mrs. Trayler: "I had to. I mean, the NASCAR race was gonna start."

Department of Redundant Radiology Department

This report crossed my desk yesterday.

(click to enlarge)

Mary, you're fired. Again.

The scroll wheel on my mouse got stuck. So I turned it over and banged it hard several times on my desk to fix it (this works, sometimes).

From down the hall Mary yelled: "Hey! What's that noise?"

I said: "I'm beating my mouse back here."

Mary yelled back: "Whatever you want to call it. Next time close your office door."


It's behavior like this that gets Mary fired. I fire her an average of 5-6 times a day.

Tuesday night, 11:57 p.m.

My cell phone rings. I recognize the number as the OB floor. Crap! The neurological complications of pregnancy are, 90% of the time, benign. The other 10% are horrible. I hate getting calls from there.

Dr. Grumpy: "This is Dr. Grumpy."

Nurse Nightshift: "Yeah, I'm a nurse on the OB floor, and need to talk to you about a migraine patient."

Dr. Grumpy: "What's up?"

Nurse nightshift: "Which medication do you recommend for migraine prevention?"

Dr. Grumpy: "Um, well there's several, I... Look, if the patient is pregnant, I try not to use them. Is this one of my patients?"

Nurse Nightshift: "Uh, no. I mean, not yet."

Dr. Grumpy: "So it's a new consult? What's her name, and what room is she in?"

Nurse nightshift: "Actually... It's me. I have migraines, and um, I, uh, guess I need to make an appointment."

Dr. Grumpy: "So there isn't a hospital case I need to be aware of?"

Nurse Nightshift: "No. Not really. Can I make an appointment to see you?"

Dr. Grumpy: "Call Mary in the morning. Good night."

Comedy in the afternoon

I'm seeing a delightful, but VERY nervous older lady, who has a new cell phone. She's quite vocal about how she doesn't like it, but her son (Michael) worries about her, and so he bought her one.

Her phone rings about a minute into the appointment. She looks at it. "Oh, it's Michael. I don't want to talk to him."

I suggested ignoring it, and letting it go to voicemail. Or turning it off.

She said: "I don't know how. And I don't want him to worry."

So she answers the phone: "Um, uh, yes, hello, this is Doris, and I'm not home, so please leave a message. Beep."

She hung up. It took everything I had not to burst out laughing.

A few minutes later the phone rings again. She looks at me and says, "I'm sorry, but I really don't want him to think I'm ignoring him".

She answers it again "Hello, this is Doris, I'm not here, and can't take your call. Please, um, leave a message again. Beep."

This time we made it another 10 minutes before Michael called again. I offered to answer it for her, to tell him she was at the doctor, and shouldn't be disturbed. Of course, she didn't want him to know that, so fumbled with the phone again.

"Um, hello. This is Doris again, and I, uh, I mean, um, you have a wrong number."

I had to run to the bathroom so I wouldn't go to pieces in front of her.

He didn't call back after that.

The lost month

This post was inspired by a recent email with ABB.

Final exams are at the end of most school semesters, including medical school. So this post is dedicated to the medical students who are hunkered down right now in their study bunkers, preparing for the worst.

At the end of the second year of medical school is the USMLE-1 (United States Medical Licensing Boards, Part 1- the name is misleading, several countries use it). This covers every subject from the first 2 years of medical school: Anatomy, Biochemistry, Pathology, Pharmacology, Microbiology, Neuroanatomy, Physiology, Histology, and a few others. 2 years of learning, all in 1 awful test. When I took it the test consisted of 4 sessions spread out over 2 days. Each session had 200 questions, and 3 hours to answer them.

At my school, if you failed the test, you had to take it again. If you failed it twice, your medical career was over (though you still owed your student loans back).

It was the Summer of 1991.

I don't remember the specific dates. But basically, between the time med school ended for the Summer, and the dreaded test, was roughly 1 month. You had 30 days to re-study everything that had taken you 2 years to learn to that point. And pretty much your chances of a career in medicine depended on how you did.

So it was stressful. And, to this day, I still feel for all of you who are out there studying for it now. Any classmate, resident, or attending who tells you they weren't scared is lying.

Within hours of the semester ending, my class had gone into hiding.

I stopped shaving, to save time. My roommate, Enzyme, disconnected our TV, moved it across the room, and piled furniture in front of it.

My days consisted of me getting up at 7:30 and showering. I'd either stay at my apartment desk or walk over to campus to find an empty classroom to study in. I'd put in my trusty earplugs and the world around me ceased to exist.

Around noon I'd go back to my apartment for a PBJ, then go study again. At 5 I'd go back to my place for a sandwich, or ramen soup, or Rice-a-Roni. I'd sit out on my balcony and eat, for 15 minutes of relaxation. Or I'd read a book with dinner (Enzyme and I were both reading a single copy of "The Price of Admiralty" by John Keegan. It sat on our kitchen table for the month, and we'd have different eating times so we could share it). I never spent more than 30 minutes on a break. After dinner I'd go back to my desk, or campus. I'd study until around 3 a.m., then go home to sleep for a few hours.

I called my parents a few times. My daily outfit consisted of gym shorts (the short kind, from the 80's), T-shirt, sneakers, and the growing beard. Days blended together. There were no differences between weekends and weekdays. People I encountered were superfluous to my existence. I saw my classmates a few times, and we exchanged glassy-eyed nods as we passed.

I shaved a night or two before the test. I studied until around 11:30 p.m. on the eve of the test, re-reviewing a few last points.

It was weird, like I was living alone on another planet for 30 days. I have no idea what happened in the news that month. I was out-of-touch with everything but my books.

If there's one thing I came out of medical school with, it was this: The realization that there was absolutely, positively, no way you were EVER going to get everything read, studied, and reviewed that you needed to before the test.

And, somehow, when the test was over and the dust had settled, you'd done it. And you'd have no idea how. I still don't.

Good luck, everybody.

Patient quote of the day

"My headaches only happen when I'm sleeping, and are gone before I wake up. I don't remember them, either. So when I wake up, I don't know if I had one or not."

Shameless Plug

For those of you who haven't started reading Fizzy, you damn well should.

I have no idea who Fizzy is, and am not getting paid for this post. But she REALLY hits the nail on the head, cartoon after cartoon. I love it.

Non-medical people may not enjoy it as much as those of us who survived med school and residency, but it's still good.

Overheard at the hospital

I'm in one of those rooms with 2 beds, and a curtain between them, examining a patient. On the other side of the curtain a lady is ordering lunch from the hospital cafeteria dial-in service.


"I'll have the BLT sandwich. I want it with cheese, too. Oh, and multigrain bread. The cardiologist told me to eat healthy."

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.