Great Moments in Psychiatry

Mrs. Lithium: "I'm so much better now that I'm on medication. They used to tell me all kinds of stuff before they finally decided I was bipolar."

Dr. Grumpy: "What did they say you were before bipolar?"

Mrs. Lithium: "Italian."

Blatant Plagiarism

I found this AWESOME back-to-school advice on The Mother's site. And she should know. She's a mother with 4 boys- and she's also a doctor. In other words, don't mess with her.

The Mother's 12 Step, Back-to-School Program.

Step #1: Refill the kid’s lunch money account online at least a week ahead. That way, you can shove the little angels out the door without hunting down spare change or playing lunchbox roulette.

#2: Prepare the child’s necessary school supplies three weeks in advance. Nowadays most schools have packet lists on the internet, and a whole lot of grocery stores sell them in those packets. Buy them prepackaged. It’s worth the extra buck, because the guys who do the prepackaging have bought out all the orange folders in town, and the English teacher only wants orange folders, and you do NOT want to have to go to the next county to get a damn orange folder. Don’t wait, though, or the little packets will be extinct.

#3: High school kids NEVER get a list in advance. They get a list from each teacher on the first day, prompting the Mad, Mad, Mad World remake at the local office supply store. YOU DO NOT WANT TO BE A PART OF THIS. Go ahead of time. Buy a $100 gift card. Give it to high schooler. Have him call you for a ride when he’s done. There’s always a Starbucks nearby.

#4: Make friends with the Amazon team. Kids always come home with a list of the books they’ll need to get for the year. They never remember to give it to you. You will then be regaled five times a year with a “last minute request.” The book will be sold out in every bookstore in the tri-county area. Steal the list from the child’s backpack on the way in the door. Go directly to Amazon. Do NOT pass go. Type in each book, and click “buy it now.” Then, when they arrive in two days , HIDE THEM until they are needed– trust me on this one.

#5: Plan take out for the first night. Stock up on advil, and buy one of those hand splints in advance, because the cramping from filling out the forms will leave you in agony for days. If you have more than one child going to the same school, get one of your kids to rig up a scanner. Or borrow a photocopier. Extra points if you are ambidextrous. Extra, extra bonus points if you make your high schooler fill them out himself and just sign. Post all emergency numbers on the white board in the kitchen and hand them all sharpies.

#6: Make sure you have money in your checkbook. It’s someone’s conspiracy that schools generally start at the end of the month, when everyone is low on funds. Then the four thousand little checks that have to be written add up–$10 for a directory, $5 for a lab manual, $15 for the debate briefs, $6 for the PTA lunch fund, … Double check your check stock, too.

#7: Do not, under any circumstances, accompany a child older than 12 into the school. They have to learn to fend for themselves sometime–Junior High seems like a good spot. Younger, if you think you can get away with it.

#8: If you do walk in with your child, leave as soon as said kid gets interested in something else. Ask any teacher–parents who hang around cause problems. Unless this is your little tyke’s first day of kindergarten, beetle out.

#9: Make transportation arrangements early. If you start driving your kids to school, they begin to expect it. Bikes, trikes, trains, buses and anyone else’s automobile are preferred.

#10: Do not allow inter-child comparison of teachers. As a mom of four, I now have three who have had many of the same teachers. They have three different takes. Squash it, fast, before poor Ms. Jones, the English teacher, gets maligned by the kid with superior math skills and NO ability to parse prose.

#11: Take advantage of the state-tax-free weekend. Take each kid out (separately). See what fits. Put that size back and buy the next size up.

#12: When the teacher asks for volunteers, RUN, do not walk, to the nearest exit. Bonus points for getting there first. (Of course, if you hadn’t gone IN, you wouldn’t be in this position).

Monday morning

Wandered in this morning to find the fax tray on my machine sagging under a pile of multiple copies of THE SAME DAMN MRI REPORT.

On perusing it I found this line at the bottom (obviously, I can't scan the real one):

"Please send copies of this report to Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D., Ibee Grumpy, M.D., Thelma Fizzy, M.D., Woody Uro, M.D.


Woody and Thelma, hope you guys had plenty of paper in your machines when you left on Friday.

It's here! It's here! It's finally here!

For the 2nd year in a row, this post is dedicated to Mrs. Grumpy.

More Dragonisms

It's a slow day, so I thought I'd just put up some Dragonisms.

(What is a Dragonism?)


Dr. Grumpy: "The MRI showed a brain tumor."
Computer: "The immoral eye showed a brain tumor.


Dr. Grumpy: "Naprosyn helps her back pain."
Computer: "A Mac person helps her back pain."


Dr. Grumpy: "He has paresthesias in both feet."
Computer: "He has penises in both feet."


Dr. Grumpy: "Joan takes Acetazolamide."
Computer: "Joan's seat is alive.


Dr. Grumpy: "On MRI he has a bulging disk in his neck."
Computer: "On MRI he has a bulging dick in his neck."

Patients from the future

Local nursing home sent this paperwork over today with a patient.

Their math sucks, regardless of how you look at it.

Just Shoot Me

Mrs. Handz: "I think I have Carpal Tunnel Syndrome. My hands and fingers go numb when I'm typing."

Dr. Grumpy: "What about when you're holding the steering wheel, while driving?"

Mrs. Handz: "Yeah, then too, and OH MY GOD! YOU'RE GOING TO TAKE MY LICENSE AWAY!"

Dr. Grumpy: "No, not at all! I'm just trying to get an idea of what triggers the symptoms."

Mrs.Handz: "I don't believe you! My friends warned me this might happen! You're going to turn me into the MVD and stop my driving!"

Dr. Grumpy: "I'm honestly not. I ask because Carpal Tunnel Syndrome can..."

Mrs. Handz: "I'm leaving before you ask more questions! I know your game!"

(patient storms out of the office)

Thursday afternoon

Mrs. Daughter: "Thank you for seeing Mom today. She's blind, and hard of hearing, so getting through to her can be difficult."

Dr. Grumpy: "How do you communicate with her?"

Mrs. Daughter: "She speaks Braille."

Neurologists- the original party animals

This picture was featured in a mailing I received. It's for a DVD program on Parkinson's disease. It is, I swear, a video of 4 neurologists arguing. Yeah, like I'm just dying to watch that.

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The distinguished faculty in the picture are named as (left to right) Drs. Sethi, Obeso, Olanow, and Stern.

Believe it or not, this is about as exciting as a party of neurologists gets. They sit around and discuss Parkinson's disease and other invigorating topics. And people wonder why I'm in solo practice.

I'm not convinced that's water in their glasses, either. Vodka, maybe.

Obviously, the star of the picture is Dr. Olanow. He looks like he's one step away from wearing a lampshade on his head. I'd like to think he's talking about his windsurfing trip over the summer, and how he accidentally ended up starring in an Absolut vodka commercial with the Sports Illustrated swimsuit models. More likely, though, he really is talking about Parkinson's disease. Only a neurologist can look so happy while talking about something that would scare everyone else away.

Let's try to guess what they're thinking:

Dr. Sethi: "Wow. Olanow has had too many already. He always gets the spotlight, and the hot drug reps. And what the hell did he do with my tie? As soon as I walked in he asked to borrow my tie because he forgot his, and now he isn't even wearing it. I have to remember to get the phone number for that Absolut girl who keeps refilling our glasses. I hope she saw that I drive a Porsche."

Dr. Obeso: "I have noooooo idea what they put in the vodka. I've only had 2 so far. I'm not touching it again. Holy crap, I hope I don't puke at the table. Olanow would never let me live that down. He'd probably show slides of it at next year's academy meetings. How come I'm the only one here who's wearing a tie?"

Dr. Olanow: "Man! Thish party is great! I better hit up Stern for cab fair back to the hotel, because I spent the travel stipend on the keg party last night. I hope nobody notices the tie I took from Sethi is missing. I gave it to that hot drug rep after writing my hotel room on it with her lipstick."

Dr. Stern: "I have to pee, and Olanow won't STFU. Maybe if I cross my legs. I didn't even see a bathroom when we came in. Maybe there isn't one. What do I do then? What the hell is he even talking about, anyway? Why does he need $20? He still hasn't paid me back from the last meeting. At least I have a good chance of getting laid tonight, because that sizzling drug rep gave me a tie with a room number written on it in lipstick."

Attention staff!

This morning I dragged in early because I couldn't sleep. To keep it quiet at home I decided to brush my teeth and shave at the office. I keep stuff here for the occasional times this happens.

You guys know that I'm usually half asleep when I come in on these days.

If I figure out which of you filled my little toothpaste tube with K-Y jelly while I was gone, you're fired.

Mary's Desk, August 10, 2010

Man comes in, signs in, stands at counter. Mary looks at his name and checks the schedule.

Mary: "Sir, we don't have you listed for an appointment. In fact, it doesn't look like you've ever seen Dr. Grumpy."

Mr. Lost: "You're wrong! I have an appointment right now!" (whips out appointment card, hands to Mary).

Mary: "Um, your appointment is with Dr. Darth, the neurologist across the street. You're at the wrong doctor's office."

Mr. Lost: "So you people screwed up my appointment? Dammit!"

Mary: "Sir, your appointment isn't at this office. I'll call over to Dr. Darth's and let them know you're on your way. Do you know how to get there?"

Mr. Lost: "Of course I do! Where is it, anyway?"

Mary: "You go back to the street and make a left turn, go 1 block down, make a right, and it's the 3rd building on the left. Here's the address."

Mr. Lost: "I don't want to pay a co-pay, since this is you people's fault."

Mary: "Well, you can discuss that with his staff when you get there. I'll call now and tell them you're coming."

Mr. Lost: "My car is low on gas. Can you drive me to his office?"

Smells like left brain

A key epilepsy question (at least to a neurologist) is "Where in the brain is the seizure coming from?"

As a result of this, we neuro docs look for clues as to which side of the brain is the seizure trigger, so to speak (we call it "lateralization"). Sometimes the answer is obvious on MRI or EEG, sometimes it's more subtle. In those cases we have to look for details in the patient's history or exam that lead us to the answer. Different findings have what we call "lateralizing value", meaning how useful it is.

Now, I'm all for further research into this. But, I have to say, some researchers looking for new lateralizing features have gone a bit too far. Or at least shown a determination to notice things that I don't want to.

(Neurology word: "Ictal" means "seizure-related")

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I'd like to thank the Science Marches On Department for bringing this important research to my attention.

Patient quote of the day

"Doc, you should have seen the way the blood was pouring out of my nose. It was, like, like, um, like really horrible diarrhea. Except it was red. And it was coming out of my nose."

Come on over, Mom, we're having a party!

I was doing some medical education credits online this morning, and came across this question. I just LOVE the 4th answer.


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