Today's Health Tip

Just reminding all my readers to eat plenty of ice cream, because it supports a healthy lifestyle. After all, it says so on the carton.

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And thank you to my reader Trout for submitting this!

Memories...

One of the most hated parts of residency is having to call an attending at night about a new admission. In most programs this is required, and you don't have a choice. It consists of dialing up the senior doc on call, running a case by them quickly, and making sure they agree with what you're doing.

Generally you try and make it quick. You're busy. They're trying to sleep.

There was one doctor in my program, Dr. Flat, who was notorious for his rapid monotone. He spoke at warp speed, but his voice never changed, and he never strayed from business. If he had a sense of humor, none of us ever saw it.

One weeknight I was on call, and was admitting a stroke patient. It was about 10:00 p.m, and I made the obligatory call to Dr. Flat.

Dr. Grumpy: "So I'm admitting him to the telemetry floor, and started him on Aspirin. I've ordered an MRI, and..."

Dr. Flat: Mmmmm. YAWNNNNNN

Dr. Grumpy: "I'm sorry, sir. Did I wake you up?"

Dr. Flat:"No, my wife and I just finished having sex. What's his blood pressure?"

Patient quote of the day

"I forget the things I can't remember. When I was younger I used to remember that stuff. I mean, I'd remember the stuff I hadn't forgotten."

Fashion and medicine

Dr. Grumpy: "Okay, we're done with the EMG. I'm going across the hall to my office. Why don't you toss the paper gown in the trash, put your shirt back on, and meet me over there to discuss the results."

Mrs. Hedinbutt: "It's not a shirt. It's a blouse."

Dr. Grumpy: "Okay. Anyway, after you have it on, come over and..."

Mrs. Hedinbutt: "Don't you even know the difference?"

Dr. Grumpy: "Well a..."

Mrs. Hedinbutt: "For crying out loud! You're a doctor and you can't even tell a blouse from a shirt! How did you get through medical school!"

(long pause)

Dr. Grumpy: "Look. Do you want to go over the EMG results or not?"

Mrs. Hedinbutt: "I don't have time for this. Just send them to Dr. Imed and I'll discuss it with him." (puts on blouse/shirt/vest/tunic/upper body garment/whatever and leaves).

Attention patients!

Your appointment is over. You are certainly welcome to wait in my lobby for your ride, to complete paperwork, or to have some water to recover from your grueling appointment with me.

However, please DO NOT USE my lobby for any of the following activities:

To use a phone (mine or yours) to make political calls on behalf of whatever candidate you're supporting this year. I respect your right to be involved in politics, but my waiting room isn't the place to do it. Not everyone out there agrees with you.

To have the sandwich, pickle, and bag of chips you've been carrying around in your purse. I don't mind you grabbing lunch in a hurry, but spending an hour here eating, calling friends, and using my magazines as napkins is a bit much (If this sounds familiar to you, asking Mary if we had any salt and a can of Sprite was over the line).

To call several local restaurants to set up catering for a party.

To try and sell real estate opportunities to other patients who are waiting to see me.

To see how much more (or less) your specialist co-pay is compared to other patients.

To hand out flyers to see your band play at Bubba's Roadhouse this weekend.

To argue about ANYTHING featured in "People" magazine.

To wait and see if a drug rep with samples of your medicine wanders in, and then assault them.

To ask my other patients what they think of your stock-market investment picks.

To appoint yourself schedule monitor, and tell Mary who signed in before whom.

To get out a scissor and cut coupons, articles, pictures, and anything else that strikes your fancy out of my lobby magazines.

Thank you.

Comparing apples to apples

Like most docs, I use Epocrates on a PDA for medication info. It's not perfect, but very helpful.

So today I had to look up something on Topamax and found this, under "Look/Sound alike drug names"

"Topamax may be confused with Topiramate"

They're the SAME FREAKING DRUG, for crap's sake!!!

(For those of you looking this up on your PDA, it's under "Safety/Monitoring")

Tuesday night, 7:15 p.m.

"Hi, Dr. Grumpy. My husband sees you for Parkinson's disease. Anyway, I'm in Calorie Counters, and we have a meeting tonight in the church down the road from your office, and our scale is broken, and I know you and Dr. Pissy have one in your hallway there, and I was wondering if you could meet us at your office and let us in to use your scale for a few minutes."

Mary's Desk, August 24, 2010

Mary: "Dr. Grumpy's office, can I help you?"

Mrs. Hiazakite: "HI! I need to get in to see Dr. Grumpy! I've heard he's wonderful!"

Mary: "Okay, we have a new patient appointment this Thursday at 2:00. Will that work?"

Mrs. Hiazakite:"I really wanted to get in today. Please? Pretty please? I'll bring you cookies!"

Mary: "That's nice of you, but I'm sorry. Thursday is our next availability."

Mrs. Hiazakite:"Will he give me some Percocet at least, like this afternoon? Just to tide me over?"

Mary: "We don't prescribe to patients that aren't established."

Mrs. Hiazakite:"That's totally unfair! Please! I said I'll bring you cookies!"

Mary: "I'm sorry, but you need to find a different doctor. I'm getting off the phone now."

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That ISN'T normal?

I went to ER yesterday afternoon to see a consult, and found this in the chart.

For my non-medical readers: EMS = Emergency Medical Services (i.e. paramedics).

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Patient quote of the day

"My headaches and stuff are about the same. I didn't start that medication stuff you prescribed last time, because I wanted to try massage and exercise stuff to see if the head stuff got any better. But the headache type stuff is worse, cuz my husband and kids and stress and stuff have had all kinds of stuff going on, so I wanted to talk about more stuff with you, like the pills and stuff, because my head stuff is getting out of control."

Can't we all just get along?

Dr. Pissy and I have shared an office for 11 years. We joke, bitch, whine, and try to make the most of our bizarre days as we work through the schedule. Day in and day out. 11 years now.

And guess what? We're on opposite sides of the political fence.

And we discuss health care, and politics, and war, and peace, and all kinds of other stuff. And we've never had an unfriendly moment doing it. Sometimes we come up with ideas that might actually work, and be an acceptable compromise. Sometimes we don't.

I'm not saying we should be in charge of anything. I mean, hell, what do we know? Maybe our ideas wouldn't work.

What I want to know is why politicians end up as the jerk-offs they often are. They must start out like us, at some point. On both sides of the aisle. Willing to talk and work things out. I mean, most of them are married, so should be used to the negotiations and compromise of REALLY complex human relationships.

So why is it that, as soon as someone actually gets elected, they revert to a preschool level of immaturity? Instead of trying to work things out, all they can do is scream, pout, and point fingers at the other children (who do the same back at them).

Every government in history has been founded on the idea of compromise. Every marriage, friendship, business, and child-raising depends on it to work out differences. So where the hell did it go in the modern government?

Is this kind of idiocy and inability to work together really something that anyone sees as being good? People refuse to work together, and then run for re-election on that idea- that they acted like a child (except I think politicians like to call it "standing up for my principles").

I suspect part of the problem is vitriolic idiots from both sides on cable news, who aren't running for office (and therefore have nothing to lose), spewing idealistic shit that may sound good to their audiences, but in reality won't work. And any politician who actually tries to work out a problem reasonably gets chewed out by these clowns as being weak and worthless.

I think all these political types need to go back to the sandbox, and re-learn basic playground etiquette: Be polite, wait your turn, share, make friends, treat others as you'd like to be treated, and WORK IT OUT.

Most governments were founded on the idea of negotiation and compromise. So why is it considered better now to just scream, pout, and do absolutely nothing? Or (my pet peeve) putting pissy little issues at the forefront to distract attention from the fact that they aren't trying to actually solve anything. It's easy to scream, but a lot harder to actually work out a solution. I don't think any of us are paying you guys to be petulant crybabies.

As you guys know, the Grumpy family likes cruise vacations. The crews on these ships are a remarkable polyglot of races, nationalities, and cultures. And they work very well together, BECAUSE THEY HAVE TO. If not, the passengers are unhappy, or the ship breaks, and they all get fired (at the minimum). So why the hell can't our elected representatives (who get paid A LOT more)?

Screaming and yelling may get you favor with whatever local groups whose ass you're kissing, but isn't in the best interests of any group as a whole. No matter what country you live in, or what side you're on.

Haiku

Summer neuro call
Lightly sleeping with a live
Bedside hand grenade

On Call Non-Sequitur

Dr. Grumpy: "Are you a diabetic?"

Mr. Blackout: "No, but I drink decaffeinated coffee."

I'm not following this

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

Mr. Gait: "I'm allergic to Flagyl."

Lady Gait: "I thought I was the one who's allergic to Flagyl?"

Mr. Gait: "No, it's me. I get a rash."

Lady. Gait: "Are you sure? I thought it makes my lips swell?"

Mr. Gait: "No, that's Penicillin. That's what you're allergic to."

Lady Gait: "No, you're allergic to Sulfa, and one of the kids is allergic to Penicillin."

Mr. Gait: "Then who's allergic to Flagyl?"

Lady Gait: "Doctor, what's Flagyl?"