"Check this out" indeed

I'd like to thank my reader Boris for submitting this product placement issue. I suppose it's a marketing campaign of the "Warning: choose one, or get the other" sort.

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Reptile WIN!

I got a hospital consult to see a guy who'd suffered a closed head injury, so I wandered over to see him. The admitting note began like this:

"77 year old male who fell and struck his head. While working in his yard he was attacked by a snake. He pulled off his artificial leg to bludgeon the snake with it, then lost his balance and fell. He hit his head on a rock, and was knocked unconscious."

How to drive an ER doc nuts

Dr. Grumpy: "Okay, I'll swing by and have a look at her. Who's admitting her?"

Dr. Er: "Doctor Hu."

Dr. Grumpy: "Who?"

Dr. Er: "Hu."

Dr. Grumpy: "Dr. Who, the TV show?"

Dr. Er: "No! Dr. Hu, the hospitalist."

Dr. Grumpy: "That's what I asked? Who's admitting her?"

Dr. Er: "Hu."

Dr. Grumpy: "Who?"

Dr. Er: "Grumpy, you're a pain in the ass." (click)

Mary's desk, June 16, 2010

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

Miss Multiplex: "Um, yeah, I need to make an appointment for Suzy."

Mary: "Okay, what's she coming in for?"

Miss Multiplex: "She has migraines. We both have Blue Cross."

Mary: "Okay, when can she come in?"

Miss Multiplex: "Umm... I'm not sure. I don't know when she'll be here."

Mary: "Is she traveling?"

Miss Multiplex: "No, she's one of my personalities."

Addictions

Like most neurologists, I read EEG's. These are tests that record a patient's brainwaves, usually done to see if the patient may be having seizures.

During one the tech running it types notes at the bottom of the screen, letting me know if the patient is talking, blinking, whatever, because these are things that can change the way the record looks.

So this morning I was reading a study, and this note floated by at the bottom of the screen.

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More time issues

Dr. Grumpy: "Has it been busy at work?"

Mr. Pillz: "Unbelievably crazy! We're working 60 hours a day, 6 days a week. And that's 24/7."

Logic

Dr. Grumpy: "Have you had any seizures since your last visit?"

Mrs. Ictal: "Two. They both happened when I was napping on the couch."

Dr. Grumpy: "Okay, then let's try raising your medication dose to..."

Mrs. Ictal: "Oh, we don't need to make any changes. Now I only nap on the bed."

What?

Dr. Grumpy: "Let me fill out an MRI scheduling form... Do you prefer mornings or afternoons?"

Mr. Timewarp: "I'd rather do an afternoon, but only if it's not in the morning or before 12:00."

Take me out to the ball game

So, yesterday the hospital gave us lowly doctors a trip to the baseball game, to cheer on the Grumpyville 9. They offered us discount tickets ($5 each) and so the Grumpy gang dug out some baseball hats, foam fingers, and other junk, and headed for the park.


Okay. Let's go. There's the gate. Wow. I can't believe how much they charge for parking. No, Frank, I have no idea what those people are protesting or boycotting or whatever. Just ignore them.

Really? Cash? How much will you pay for my tickets? Hey honey, wanna sell them to a scalper? Sorry, I can't. My wife just said she'll emasculate me if I do.

Already, Marie? Christ, why didn't you go at home? Okay, there's one over there. You're hungry, too? All of you are? Didn't we give you Goldfish Crackers in the car? Fine. We'll get some food before we find our seats.

Okay, 5 hot dogs, some nachos. Frank, can you help me carry this? Thanks. Good thing the bank has an office here, so I could take out a home equity loan to pay for the food. I never thought I'd see the day where Disneyland food looked cheap.

Don't spill the Diet Cokes, Frank, or you'll die. We're over in "special section" G-17, whatever that means. I think it's over there.

Here we are. Hold my tray so I can show the guy our tickets.

WHATTHEFUCKDOYOUMEANTHATALLTHEFOODINTHESPECIALSECTIONISFREE?!!!

HOLYCRAPIJUSTTOOKOUTASECONDMORTGAGETOPAYFORTHESEHOTDOGS!!!

Great. Okay. Let's take that table over there.

You're done with your hot dog Craig? Go get another one. The free buffet is over there. I don't care if you're not hungry. We're gonna get our money's worth.

Marie, don't wear the foam finger on your head during the national anthem.

Oooh, there's that new cardiologist, the hot blond lady, at the Coke machine... And some of the cute family practice residents are over at that table by the nachos... No dear, I'm just reading the scoreboard.

Crap. Dr. Loud is here. He's so obnoxious. He's making the rounds, too. I hope he doesn't come to our table.

I'm going for another hot dog. No, Frank, I don't care if you're full. Go get some more nachos. We may not feed you for another week.

HOME RUN! GRUMPYVILLE HIT A HOME RUN! THE CROWD GOES WILD! STAND UP AND CHEER, KIDS!

OMG! That cute little family practice resident doesn't shave her pits! Don't think I wanted to see that...

Marie, have some more popcorn and peanuts. No, I don't care. Shut up and eat. Find room.

Dr. Loud is at the table next to us. Crap. I don't want to talk to him. I hope he doesn't come sit with us next. Kids, don't look at him. His hideous shirt may blind you.

Grumpyville is down 5 to 1 in the 3rd inning. This isn't looking good.

No, Marie, I don't know when, or if, they're going to put dessert out. Go have another hot dog, and bring some back for your brothers.

Honey, how many of these hot dogs do you think you can fit in your purse? We could have some for dinner tomorrow, too.

Gang, you know the rules of baseball. You don't cheer wildly every freaking time somebody on either team hits the ball. That doesn't always mean something good.

The other team scored again. I'm going to go get some more nachos.

Oh, there's the hot blond cardiologist down on the concourse. Looks like she brought her sister to the game.

They're making out. I'm starting to think that's not her sister.

The other team scored again.

Frank, Craig, go have another hot dog. I'll be damned if I let the stadium come out ahead on this deal.

Where's Marie? Oh, she went to go ask when they're putting out dessert.

Where did Dr. Loud go? He's over there now. Good. I hope he skips our table. I can't stand him.

Frank, if you hit that lady with your foam finger again, she's going to punch you out, and I won't blame her, either.

The other team scored again... What all that noise?

Holy crap! Soomebody's kid is attacking the food-service guy who's taking care of the hot dog trays!

Shit! That's MY kid! MARIEEEEEEEEEE!!!!!!!!!!!!!!!!!!!!!!!!!!

I'm sorry, sir. I really am. Here's a tip. Sorry. MARIE! Go sit over there!

Marie, you can't start kicking the waiter just because he told you that there's no dessert coming.

The other team scored again.

Hey! Dr. Loud is leaving! WTF? Hey, you fat slob! You schmoozed with every other damn table here EXCEPT MINE? What's up with that? Me and my family aren't good enough for you? What an obnoxious prick.

Let's go, people, this game is pathetic. Grumpyville is down 9-2 in the 5th inning. Everyone grab 2 hot dogs. We're gonna live off this stuff for the rest of the week. And some of those relish packets, too.

No, we are NOT buying ice cream on the way out.

Where the hell did we park?

Sunday morning, 5:05 a.m.

"Hi, I see Dr. Grumpy for my MS, and am scheduled for my shot tomorrow. I got hit over the head with a small poodle yesterday, and was wondering if I should hold off on the injection for now?"

I'll miss you, Lady

Patients die. It's part of life and medical practice.

But last week one of my favorite patients died, and I'll miss her.

Due to shit luck she's been in a wheelchair for the last 15 years with a serious neurological disease. It made her suffer constantly from pain. When a freak accident cost her an eye 10 years ago, she accepted it as the crap it was, and went on with her life. She never once filed for disability. And in spite of this she was always cheerful.

I saw her every few months. Not that I really had much to offer her, but she came in to see if anything new was out. And when I said no, she accepted it with grace. I told her she didn't need to come back for a year, but she'd always be back sooner. Over the years our appointments became as much social visits as they were medical. So we'd chat about shoes and ships and ceiling wax.

She knew about this blog, one of a handful of patients who does. She'd been through so many doctors and tests and treatments that she loved to laugh at the insanity of modern medicine. She'd always joke with me that she was looking for herself on it, but I told her she'd never given me anything to write about.

And so it seems fitting, that, in dying, she finally ended up here.

She went to Local Hospital ER for pain 2 nights ago, and they sent her for a CT scan. While in the machine, she died. The code team worked on her for an hour in radiology, and couldn't get her back.

I learned of her death yesterday, and went over to read the chart, to see what happened. I was reading through the Code Blue note. Which ended with this line:

"After being pronounced dead, the patient was returned to ER for further evaluation and treatment."

Good night, Lady, wherever you are.

Attention patients!

The emergency room is for EMERGENCIES!!!

I'm sorry if you're frantic to have your test results back from Local MRI, but going to the ER, hoping that maybe they'll be able to get them faster for you, for the same damn symptoms you saw me for 2 days ago in my office, is an absolute waste of everyone's time and money, including YOURS.

In fact, we'd already left a message on your answering machine AND voice mail that the test was fine (surprisingly, it even showed a brain), but you'd already gone to the ER for this incredibly stupid reason, and had turned off your cell phone when you got there.

Minor difference.

I'd like to thank my reader Dr. Phil, for submitting this to show me that my office isn't alone.

Receptionist: "Dr. Phil's office. What can I do for you?"

Mr. Gloom: "I need to make an appointment."

Receptionist: "Okay... Is it to see the doctor? Or to have blood drawn?"

Mr. Gloom: "To draw blood. I need to have labs done before my autopsy."

Receptionist: (looking through the schedule) "Umm... You mean your biopsy?"

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

I think they ablated your cortex

Dr. Grumpy: "Have you ever had any surgeries?"

Mrs. Dimbulb: "I had a girl-part ablation. It was like an ovarian ablation, or uterine ablation, or vagina ablation. Something like that. Maybe they ablated my hysterectomy?"

Dr. Grumpy: "Umm..."

Mrs. Dimbulb: "Hey, what does ablation mean, anyway?"