Tuesday, June 1, 2010

Monday night, 9:27 p.m.

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

Mrs. Cabinet: "Yes, I'm one of your patients, but I'm calling about my husband. He was putting cole slaw away after our Memorial Day barbecue, and he bumped his head on a cabinet."

Dr. Grumpy: "Did he get knocked out? Or is he sleepy? Or weak anywhere?"

Mrs. Cabinet: "No, but he has this big lumpy bruise on forehead. I want an MRI on him, immediately. We can do it tonight. Just tell me where to go."

Dr. Grumpy: "Well, I really can't order that on him. I mean, he's not my patient, and I can't set up tests after office hours. The best I can suggest is that you take him to an ER, and let them assess him, and see if they feel he needs further testing."

Mrs. Cabinet: "I don't want to take him to an ER. He only bumped his head. Going there would be overkill."

Monday, May 31, 2010

Memorial Day, 2010

The lawyer from South Dakota

On memorial day, veterans graves across the country are honored with wreaths and flags. But some veterans have no graves to honor, and can only be remembered.



Lieutenant Commander John C. Waldron, U.S.N.


He & his men changed the course of World War II in the Pacific, and didn't live to know it.

He was a lawyer, born in Fort Pierre, South Dakota. His father was descended from English settlers, his mother was a Sioux Indian.

He was married, with 2 daughters.

He was admitted to the state bar in South Dakota, but rather then going into practice decided to join the U.S. Navy. He was chosen to be a pilot, in the new field of naval aviation.

He trained to fly torpedo planes (no longer in use). Their goal was to fly close enough to an enemy ship to drop a torpedo into the water, then get away as fast as possible. This was a difficult job. It required the planes to fly in a low, straight line as they approached the enemy, making them easy targets for enemy fighters and anti-aircraft.

Waldron was a good pilot. He was chosen to teach at Annapolis, and later Pensacola. He flew planes off 1 battleship and 3 carriers.

He and his wife held parties for other pilots at their Norfolk home. He was very proud of his little girls. Some pilots remembered being taken to his daughters' darkened bedroom and asked "Did you guys ever see such pretty little girls?"

With war looming in the Summer of 1941, Waldron and his men were assigned to the aircraft carrier U.S.S. Hornet, in the Pacific theater.

He was determined. He once told his pilots that "if we run out of gas, we'll piss in the tanks." He wasn't looking for glory, or to become a martyr, or a hero. He was just doing his job.

On the morning of June 4, the Hornet was somewhere off Midway island, placed there to defend against the massive Japanese force sent to capture the Pacific base.

Waldron likely had few illusions about his chances. Although his men were well-trained, their "Devastator" torpedo bombers were already obsolete. The new "Avenger" planes were much better, but only beginning to roll out of the factories. And with the enemy coming, they had to make do with what they had. Before the battle he called his men together and said "If there is only one plane left to make a final run in, I want that man to go in and get a hit."

The Japanese "Zero" fighter was a lethal weapon. Though poorly protected, it was quicker and more maneuverable than it's American counterparts. And it was flown by some of the best pilots in the world.

On the morning of June 4, 1942, Waldron led Torpedo Squadron 8 off the Hornet. He had orders to search for the Japanese in a specific area, but had a hunch (he called it his "Sioux intuition") that the heading he'd been told to follow was wrong. He disobeyed orders, and it turned out his intuition was correct.

Waldron led his 15 planes straight to the enemy fleet. Forced to fly straight & low to aim their torpedoes, they were sitting ducks as the Zeroes swooped down and destroyed them one by one. Out of 30 men, there was only one survivor, Lt. George Gay. He saw Waldron stand up in his plane as it burst into flames, just before his own plane was shot out from under him. They didn't get a single hit.



The 15 pilots of Torpedo Squadron 8, photographed in May, 1942. Waldron is standing, 3rd from left. Lt. George Gay, (circled, 1st row) is the only man in the picture who survived.

In a few minutes all the planes of Torpedo Squadron 8 had vanished beneath the Pacific, leaving only Lieutenant Gay hiding from the Zeros under his flotation device. It was a disaster for the Americans.

But unbeknownst to all but Lt. Gay, they changed the course of the Pacific war.

The deadly Zeroes were now at sea level, on the prowl for more torpedo planes. But the next American wave, this time of dive bombers, was high above. They might have been easy targets, too. But as they came down the Zeroes were no longer in a position to defend their fleet, and couldn't gain altitude in time to stop the bombers. Between 10:20 and 10:25 a.m that morning the Japanese lost 3 of their 4 aircraft carriers to the bombers. The last carrier followed them a few hours later.

The loss of the four carriers, with their planes, pilots, and crews, was a blow the Japanese navy never recovered from. The war went on for 3 more years, but the tide was turned by the sacrifice of a group of men, led by a 41-year old lawyer from South Dakota.

A
ll my readers, no matter what country they're in, owe their freedom to soldiers in all military branches. So remember them today.


The fallen from Torpedo Squadron 8. Their only grave marker is the blue Pacific water.

Lt. Commander John C. Waldron
Lt. Raymond A. Moore
Lt. James C. Owens, Jr.
Lt.(jg) George M. Campbell
Lt.(jg) John P. Gray
Lt.(jg) Jeff D. Woodson
Ens.William W. Abercrombie
Ens. William W. Creamer
Ens. Harold J. Ellison
Ens. William R. Evans
Ens. Henry R. Kenyun
Ens. Ulvert M. Moore
Ens. Grant W. Teats
Robert B. Miles, Aviation Pilot 1c
Horace F. Dobbs, Chief Radioman
Amelio Maffei, Radioman 1
Tom H. Pettry, Radioman 1
Otway D. Creasy, Jr. Radioman 2
Ross H. Bibb, Jr., Radioman 2
Darwin L. Clark, Radioman 2
Ronald J. Fisher, Radioman 2
Hollis Martin, Radioman 2
Bernerd P. Phelps Radioman 2
Aswell L. Picou, Seaman 2
Francis S. Polston, Seaman 2
Max A. Calkins, Radioman 3
George A. Field, Radioman 3
Robert K. Huntington Radioman 3
William F. Sawhill, Radioman 3

Saturday, May 29, 2010

Insurance premiums at work

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

Mr. Shakes: "Yeah, I see you for epilepsy, and I missed my medication this morning, and I just had a seizure."

Dr. Grumpy: "Okay, have you taken another dose?"

Mr. Shakes: "Yeah."

Dr. Grumpy: "Good. So are you doing okay now?"

Mr. Shakes: "Yeah, I'm fine. I feel good. I'm going to go over to ER after the game."

Dr. Grumpy: "Why? It sounds like you don't need to. Are you back to normal?"

Mr. Shakes: 'Absolutely. But I wanna go get checked out."

Dr. Grumpy: "Okay, but..."

Mr. Shakes: "I'M GOING TO ER, DAMN IT!"

(hangs up)

May 29, 1914




If you read the popular stuff, you'd think there were only 3 major shipwrecks of the 20th century: Titanic, Lusitania, and Andrea Doria. Obviously, there are many more, even if you exclude 2 worldwide conflicts in the last 100 years. The worst peacetime shipwreck in history, the Dona Paz (Philippines), took 4,375 lives as recently as 1987. And I bet you've never heard of it.

Trans-Atlantic crossings have always been critical to both sides of the Atlantic (look at the chaos caused by the recent Icelandic volcanic eruption). Although the giant liners of Cunard and White Star are best remembered, they were by no means alone. Ships were constantly coming and going, carrying passengers and freight, both ways across The Pond.

Although less glamorous than the liners that sailed in & out of New York, there were many busy ships that called on the Canadian ports. One was the Empress of Ireland, which in 1914 was serving the Quebec City to Liverpool route.

Early this morning, 96 years ago, the Empress was outbound from Canada. She was heading northeast on the St. Lawrence River. It was 2:00 a.m., and most of the passengers were sleeping.

In a thick fog, the Norwegian coal-carrier Storstad struck the Empress on the starboard side. The damage was extensive. There was only limited time to sound an alarm, and electricity failed quickly, plunging the ship into darkness. The Empress was gone in 14 minutes.

The survivors were picked up by the few lifeboats that had been launched, and were carried back and forth to the Storstad, which had stayed afloat. Captain Henry Kendall, who was thrown into the water as the ship rolled over, supervised the rescue efforts and likely saved many lives by organizing the lifeboats.

All together the Empress took 1,024 people with her. It remains the deadliest maritime disaster in Canadian history. In spite of this, the ship is mostly forgotten today. The St. Lawrence Seaway is a very busy channel. Hundreds of ships steam over the Empress every day, very few knowing of the tragedy beneath them.

The Salvation Army remembers. A large contingent of members (167) were lost on the ship, traveling to a conference in London. There is a monument to them at Mount Pleasant Cemetery, in Toronto.

The Empress of Ireland is in 130 feet of water, well within the range of scuba equipment, but the currents and poor visibility limit diving

Friday, May 28, 2010

Idiots on vacation

Dr. Grumpy: "How was your trip to South America?"

Mrs. Insensitive Tourist: "It was fine. But Chile was a dump. That earthquake was what, a month or two ago? You'd think they could have the place cleaned up and fixed by now."

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."

Thursday, May 27, 2010

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)

Wednesday, May 26, 2010

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."

Tuesday, May 25, 2010

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.

Monday, May 24, 2010

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."
 
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