"Hey! Why doesn't this floor have call lights?"

Mr. Stemi: "When I had my heart attack I was on the telepathy floor for a week."

Dr. Grumpy: "You mean the telemetry floor."

Mr. Stemi: "Yeah, whatever it's called."

Your researchers at work: hockey surprise

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

Okay, gang. The reputable Journal of the American Medical Association has apparently decided to demonstrate that idiotic research is done not only in the U.S. (and Haifa, but that's a city, not a country) but also by our friendly neighbors to the north.

Yes, a team of Canadian researchers has made the stunning discovery that hockey players who give and receive body checks during a game are more likely to suffer serious injuries than hockey players who don't.

I am not making this up.

The original article, if you must read it yourself, is:


Risk of Injury Associated With Body Checking Among Youth Ice Hockey Players

JAMA. 2010;303(22):2265-2272.

Dear Mrs. Frosting,

Congratulations on your first wedding anniversary!

I know a lot of people save a layer from their wedding cake, to eat on the first anniversary. I have no problem with that (I don't remember anymore if we did or not, but if I ask Mrs. Grumpy she'll kill me for forgetting that important point).

Anyway, I'm sorry the cake was so badly freezer-burned that it was inedible. Sometimes that happens. I'm sure you were disappointed at having to throw it out.

Apparently, though, you couldn't bring yourself to do that. So why on Earth you decided to dump it off at my office as "treats for the staff" I have no idea. I can only assume you don't have neighbors or co-workers that you hate enough to give it to.

Mary and Annie have put your thoughtful wedding souvenir in an appropriate place. If the Audobon society calls tomorrow asking about a large number of dead pigeons near our dumpster, we're giving them your name.

Monday afternoon goes to hell

Sorry, guys, today was a disaster. Due to a problem in my office building, I had no internet at all. They tell me it may not be up tomorrow, either. Anyway, I apologize for not being able to put up your comments or post today's insanity earlier. But Grumpy Neurology, P.C. had temporarily been reduced to Screaming Obscenities into the phone at the ISP Neurology, P.C. instead.


Dr. Grumpy: "So we got you a wrist brace, and you went to physical therapy for the carpal tunnel syndrome. How's it been going?"

Mr. Mano: "Better. The therapy place is good. The staff there did a really good hand job. Um, I mean, job on my hand, because it felt really good and... Doc, that doesn't sound good, does it?"

Dr. Grumpy: "No, but I think I understand what you mean."



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Jobs

Like most doctors, I get boatloads of job offers. Tons. Every freaking day in the mail.

"Great Opportunity! Live in scenic Nofuckingwhere! Incredible Salary!"And they always have pictures of stunningly attractive men and women, with amazingly cute children, doing outdoor activities. Or attending the theater. Or doing anything but wading through a huge pile of charts with a lobby full of patients. They make the jobs sound so wonderful that you wonder why the previous doc left.

These things have all sorts of catchphrases about remarkable salary, fast-track to partnership, limited call, great public schools, outdoor activities, cultural events, etc. Usually it runs something like this: "Practice in a beautiful area, where you can live 5 minutes from the beach, mountains, and international opera house. World class schools in an area with absolutely no crime, drug problems, or pesticides. Enjoy year-round skiing, golf, wind-surfing, fishing, kayaking, and snowboarding. Call schedule is 1 in 365, with no hospital coverage. Earn $175 billion dollars a year and a generous program to help you pay back your med school loans, with a fast-track to partnership."

So, as a courtesy to other medical professionals, I've waded through these things and collected the most commonly used phrases, and now offer a translation:

"World Class Medicine": (which world? Neptune?)

"Directorship position": You're the only doc for 500 miles.

"Practice without limits": Patients will push the envelope like you wouldn't believe.

"Short drive from recreational opportunities": Not that you'll ever have time to go, but you can drop the kids off on your way to work.

"Theater events": The high school kids put on "Li'l Abner" in the fall.

"Low Crime rates": Everyone has a gun, and shoots on sight.

"Invigorating river nearby": We're downstream from a sewage plant.

"Unique patients": Inbred families with webbed fingers.

"Fine shopping": We have a Walmart AND a Target!

"Fine local cuisine": Whoppers, Big Macs, AND Wendy's"

"Wholesome community": Minorities kept out at gun point.

"Join a growing practice": You're it.

"Moving bonus": Biff will come help you unload your truck

"University town": ER is full of drunken fratboys.

"Physician-friendly hospital administration": And you can see Bigfoot here, too. Pigs also fly.

"Competitive salary": You'll make more than you would at the local McD's. But not much.

"Generous benefits": Secretary has a bowl of M&M's on her desk.

"Cultural offerings": Office fridge hasn't been cleaned in years.

"Topnotch school system": Most kids finished 8th grade.

And my favorite:

"Year round activities": What does that mean? Hell, cleaning my house is a year round activity.

Sunday morning, 6:47 a.m.

My cell phone rings. It's the hospital ID.

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

Ms. Huc: "Hi, I'm calling from 7-East. Did you get a consult on Mr. Whacky on Friday?"

Dr. Grumpy: "Yes, but when I spoke to the internist he told me it had been written by mistake, and that they didn't need a neurologist. So I didn't see him."

Ms. Huc: "Ohhhhh... I was just looking through the chart, and trying to figure out why you didn't see him."

Dr. Grumpy: "Do they need him seen now? I can come in later today."

Ms. Huc: "Hang on, let me ask his nurse." (pause) "No, never mind. He went home last night."

Memories...

In residency, young doclings have clinics, learning how to do outpatient medicine in the hopes that we'll be able to do it when we grow up.

Grizz, another resident in my year, had a clinic epilepsy patient who had HUGE surgically enhanced breasts. She also used craploads of make-up.

Anyway, another resident was getting married, and so we planned a bachelor party for him over at Local House of Boobies. It was a fairly successful event (from what I remember) involving alcohol, topless dancers, a large number of $1 bills, and I think some silly string.

Anyway, at one point I paid a stripper to come over and give Dr. Bachelor a lap dance. So she got started doing her thing, then abruptly stopped. She looked at Grizz and said, "Hey! You're Dr. Grizz! I see you over at the epilepsy clinic!"

Grizz looked like he wanted to die. He turned a shade of red I hadn't seen before or since.

She walked over and rubbed her breasts on his head "You're awesome! I love that new drug you have me on, because it doesn't affect my balance when I'm dancing!"

Then she resumed the show.

Grizz didn't go to anymore bachelor parties after that.

Sitcom in my office

Mr. Patient: "Dr. Internist told me to see you about my arm pain. He also wanted me to mention that I'm having memory loss."

Dr. Grumpy: "Okay, let's start with the arm. How long has it been hurting you?"

Mr. Patient: "I don't remember."

Things that make me grumpy

I had a hospital consult yesterday afternoon. So I swung by the doctor's lounge to grab a Diet Coke, and then went to find my patient.

While I was waiting for the elevator, I popped the can open. Unfortunately, it exploded, showering me and the floor with soda.

Shit happens. Oh well. I ran to the bathroom next to the elevator, grabbed a handful of paper towels, and came back to clean up the mess.

As I'm working on it, Dr. Helmsley wanders by, and asks me what happened. I told him my Diet Coke exploded, and so I'm cleaning it up.

He laughed and said "I wouldn't bother. You're a doctor. The hospital pays drudges to do that." Then he walked away.

Screw you, Dr. Helmsley, and anyone else who thinks like that. Just because we have advanced degrees and training, DOESN'T EVER exclude us from normal courtesy. My mother always told me that if I make a mess I should clean it up. Not leave it for someone else to deal with.

And if you think being a doctor , or driving a Porsche, or ANYTHING exempts you from that, then your mother needs to slap the shit out of you.

Attention patients, drug reps, and planet Earth!

Mary is trying to quit smoking.

Therefore, DO NOT, under any circumstances, give her attitude.

If you do, we at Grumpy Neurology, P.C., cannot be held responsible for anything she may do to you. And believe me, you don't want to find out.

Any attempts to give Mary attitude are at your own risk. So don't say I didn't warn you.

Wednesday afternoon front desk insanity

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

Mrs. Nutz: 'Yes, I need to make a new-patient appointment."

Mary: "Okay, we can see you tomorrow morning, at 11:00."

Mrs. Nutz: "I'm having a lot of leg pain. Can your doctor find out what's wrong, and fix it?"

Mary: "Well, he'll do his best, I mean, he'll need to evaluate you and..."

Mrs. Nutz: 'I'm leaving on a vacation this Sunday, and I need this problem fixed by then. Otherwise it will ruin my trip. Is he going to be able to do that?"

Mary: "Well, like I said, he hasn't even seen you yet, so it's hard to..."

Mrs. Nutz: "Well I need it fixed. This is ridiculous."

Mary: "Okay, how about I get you scheduled? What's your insurance?"

Mrs. Nutz: "I have a very high deductible, so I'll be paying all of this out of pocket. How much is it?"

Mary: "Well the appointment is $300, but if you need tests done it..."

Mrs Nutz: "$300!!! That's insane! Okay, I'll bite. But I will only pay it if your doctor can guarantee, in writing, that I will be figured out and completely fixed before I leave on my trip. Otherwise I want my money back."

Mary: "We can't do that. I won't schedule you under such a condition. I don't know any doctor who will see you like that."

Mrs. Nutz: "Doesn't anyone want to help patients anymore? Whatever happened to that damn oath they take?" (Hangs up).

Not helpful

Dr. Grumpy: "Are you allergic to any medications?"

Ms. Vague: "Yes, several."

Dr. Grumpy: "What are their names?"

Ms. Vague : "I don't know. Can't you get the list from my last doctor?"

Dr. Grumpy: "Okay, we'll have you fill out a release... What's that doctor's name?"

Ms. Vague: "I have no idea. It was a man. I think I saw him when I lived in Missouri. Does that help?"

You can't afford to be sick!

I hate these ads.

You've seen them. They're in newspapers and regional magazines across the country. Some smiling mom and her cute kid. It's an ad for some local clinic, always with a tagline like "You can't afford to be sick!" or "You don't have time to be sick!".

And they list things they treat, like headache, sore throat, ankle sprain, runny nose, and skinned knee (who the hell goes to the doctor for a skinned knee?). They make no mention of heart attack. Or accidental amputation. Or arrow through the head.

It's so comically misleading. As if there's something abnormal about being sick. Face it. The germs outnumber us. Being sick is part of the price of doing business of Earth. We all catch the crud here and there. And we all trip and fall, spraining this and scraping that.

These ads give the impression that it's horribly abnormal to catch some mild illness or suffer a minor injury. Better yet, they make it sound like they can magically fix you, like they're going to wave a wand, and the germs will suddenly vanish or you'll grow new skin immediately.

All they do is give you Sudafed and/or Tylenol and/or a band-aid, (which you could have bought yourself) and bill your insurance.

What really peeves me is that this enforces a cultural dependency on medical care. Yes, I'm a doctor. Medical care is how I earn a living. And there are certainly MANY conditions where you absolutely, positively, should see a medical professional. And I know sometimes it's hard to know what's what.

But did your Mom send you to the doctor for every little thing? (I know, some Moms did) Probably not. She sent you to bed, gave you some Tylenol, and told the school you were out. Or she gave you Tylenol and sent you to school.

And I'm willing to bet you felt a hell of a lot sicker at some point in college, after toga night at McBarfy's house of cheap beer. And you didn't see a doctor for that, either.

We have a lot of treatments in medicine. But the majority of things you get in your everyday life will get better with or without a doctor.

"The art of medicine consists of amusing the patient while nature cures the disease."

Voltaire wrote that around 250 years ago. And, for the most part, I won't argue with him.

So you are

Dr. Grumpy: "Any major illnesses in your parents?"

Mr. Huh: "I don't know. I'm an only child."