Sunday morning, 2:25 a.m.

"Hi! I'm a patient of yours and I'm 8 months pregnant and my water broke and I've started having regular contractions and I think I need to go to the hospital and can the doctor please call me back ASAP because OH SHIT! I THINK I CALLED THE WRONG DOCTOR PLEASE IGNORE THIS MESSAGE!"

(click)

I still can't stand it.

This is a repeat of a post I ran last September. And since the same issue STILL drives me nuts, I'm putting it up again.


Dear Mr. President,

I don't want this to be a political blog. There are plenty of other sites for that. But we now face a national crisis of such serious proportions that it dwarfs other issues, such as global warming, health care, and middle-east peace. It now threatens the very fabric of our society, and directly affects every citizen. And I can remain silent no longer.

It's still September, and every store near me ALREADY HAS THEIR CHRISTMAS DECORATIONS UP!

I have nothing against the holidays, Mr. President. Peace on Earth and all that stuff. But moving them up as if they were being held in another time-zone or alternate universe is getting out-of-hand. As far as I know, Christmas hasn't budged in my lifetime. And treating every day like it was Christmas (like the stores seem to want me to do) is not helping.

The well-respected Nick documentary program, The Fairly Oddparents, has carefully researched what would happen if Christmas were held every day (Episode 107, air date 12-12-01 I have kids, OKAY!). Their conclusion? It would be catastrophic.

There also seems to be a degree of unintentional discrimination. For example, Hanukkah starts more than 3 weeks before Christmas this year, but I didn't see Hanukkah decorations going up 3 weeks before the Christmas ones. In fact, I haven't seen any at all yet. Or Kwanzaa stuff. Or Festivus. Or New Year's.

This seasonal perversion extends to other holidays, too. I mean, by January 2nd most stores are decked out with Easter junk, and on July 5th the Halloween crap is up.

So, Mr. President, I propose the following, federally mandated solutions (please note: I'm only including those holidays that retailers love. Let's face it, not many of us are out there buying gifts for Groundhog day or cards for Columbus day. I'm also leaving out local holidays like Delaware Statehood Day, the Montana Huckleberry Harvest Celebration, and the Byron, Illinois, Turkey Testicle Festival).

Valentine's Day Decorations will NOT be put up until the 3rd week of January.

St. Patrick's Day Decorations will NOT be put up until after March 1st.

Passover/Easter decorations will NOT be put up until after St. Patrick's day.

Independance day decorations (July 4th) will NOT be put up until the 3rd week of June.

Halloween stuff will NOT be put up before October 1st

Thanksgiving Stuff will NOT be put up before November 1st.

Christmas/New Year/Hanukkah/Kwanzaa/Festivus stuff will NOT be put up until the day after Thanksgiving.

(Please note: there should be some flexibility here, as Hanukkah and Easter/Passover may vary, but decorations should NOT be hung more then 3 weeks prior to holiday onset).


An alternative plan would be to have a single annual holiday combining all of the above, called St. Christmukahpasseastkwanpatfourthnewfestgivingween. Decorations for the combined holidays may be hung for 30 days prior to this event, and MUST be removed the day after.


Punishment for business owners who violate these laws would be on a 3-step basis:

1st offense: Business license revoked for one month.

2nd offense: Tarred, feathered, and forced to eat fruitcake.

3rd offense: Drawn and quartered, then served with fava beans and a nice chianti.


Yours truly,

Ibee Grumpy, M.D.

Tough case

I'm reading a hospital discharge summary, and discovered this quote from a neurosurgery resident:


"The patient was given Valium 10mg and Haldol 10mg. He then become lethargic, with decreasing oxygen saturations. The cause of his sudden lethargy was unclear. A head CT was unremarkable, and a STAT neurology consult was called."

Doctors for Gooder English

Doing an online survey this afternoon, and encountered this question.

Gosh, I wonder what happened?

Yesterday afternoon I went to the hospital's EEG reading room to look at the day's studies.

Unfortunately, only one had gotten done all day, and there was a note on the monitor that said "Doctors, sorry we couldn't do all the studies today. We had to send the EEG machine to Bio-Med to have it thoroughly cleaned".

Lucky for me, it was one of my studies that did get done. It was on a confused ICU patient, so I started reading it.

The study ended abruptly at 8 minutes (normally they go for 20), with the following commentary in the tech notes:

0745: Pt yawning.
0748: Pt moving around, agitated.
0750: Pt pulled poop tube out of butt and is playing with it. Nurse running to bedside.
0751: Ending study.

Mary's Desk, September 22, 2010

(Lady comes in, signs in, then continues to stand at counter)

Mary: "Hi, Mrs. Patty. We'll get you back in a sec. Do you need something?"

Mrs. Patty: "Um, yeah, do you guys have a hamburger I can have?"

Mary: "Excuse me?"

Mrs. Patty: "Do you have a hamburger? I just dropped my mom off at the airport, and I'm really hungry."

There's a lot of that going around

For the original post on this topic, click here.


Dr. Grumpy: "Did you have an X-ray for the neck pain?"

Mrs. Daypro: "Yes. A friend said the carpal tunnel there is causing my neck problems."

Now THAT'S ambitious!

I'd like to thank my reader Miriam for submitting this. She noticed it in a hospital patient's (admitted for a knee problem) paperwork .

(click to enlarge)

And now for something completely different

Okay, people. Yours truly, Dr. Grumpy, has been asked to host (drum roll please) ONLINE GRAND ROUNDS next Tuesday. As many of you know, this is a weekly collection of blog posts of a certain theme.

Next week starts the 7th year of this, and they wanted someone talented, popular, and successful to host it. Unfortunately, that person wasn't available, and so they asked me instead. I've been assured that their decision to pick me was based on stringent criteria, such as having a pulse and a website. I tried to negotiate for a case of Diet Coke, without success.

So the topic for next week's Grand Rounds will be "Things that make me grumpy". I whine enough, so I'm opening up the floor to you guys. Please submit links to blog posts following this theme, but try to keep them (roughly) in some limits:

1. They should have at least SOME medical background to them. I don't want to hear about the guy who cut you off in traffic (unless it was a neurologist wired on Diet Coke), the crappy service you got at Denny's, or the high cost of flour.

2. Try to have some element of humor in it.

3. This is NOT a political blog, so I'm NOT going to put up rants from either side about health care, elections, or whatever.

How to submit: Please send your entries to pagingdrgrumpy [at] gmail [dot] com. Put "Grand Rounds" in the subject line, and include the URL of the post in the message, with a sentence or two about it. Sending huge amounts of money to my Paypal account is also recommended, but not necessary (nudge nudge wink wink).

The deadline will be Saturday, September 25, at 6:00 p.m. U.S. Eastern time. So submit early. Or else.

Urgent matters

Dr. Grumpy: "Have a seat. I'm Dr. Grumpy."

Mrs. Arowana: "Thank you. Pleased to meet you."

Dr. Grumpy: "What can I do for you?"

Mrs. Arowana: "Well, for the last 7 years I've had... Oh! I need to leave. I'm sorry!"

Dr. Grumpy: "Is something wrong?"

Mrs. Arowana: "I forgot to turn on the light in my fish tank after I cleaned it this morning!"

Dr. Grumpy: "But..."

Mrs. Arowana: "No, I have to go deal with this. The fish are my babies, and I don't want them to get angry at me."

(patient walks out)

Dear Ambien-CR,

Thank you for recently sending patient information packets to my office (I've already safely recycled them, don't worry).

I know your logo is a rooster. I still don't understand this, since the drug is supposed to make you fall asleep, NOT wake you up. But whatever.

Anyway, considering another term for rooster is "cock", and we all know what that's slang for, perhaps you should think of a better package design than this. Or maybe license the logo to Viagra, instead.

Because somehow I can just see this ending up in a novelty store next to a mistletoe belt buckle.

Dead men tell no tales...

Yo ho, yo ho, a pirate's life for me!

We pillage, we plunder, we rifle, and loot,
Drink up, me hearties, yo ho.
We kidnap and ravage and don't give a hoot,
Drink up me hearties, yo ho.

Yo ho, yo ho, a pirate's life for me!

We extort, we pilfer, we filch, and we sack,
Drink up, me hearties, yo ho.
Maraud and embezzle, and even hijack,
Drink up, me hearties, yo ho.

Yo ho, yo ho, a pirate's life for me!

We kindle and char, inflame and ignite,
Drink up, me hearties, yo ho.
We burn up the city, we're really a fright,
Drink up, me hearties, yo ho.

We're rascals, scoundrels, villains, and knaves,
Drink up, me hearties, yo ho.
We're devils and black sheep, really bad eggs,
Drink up, me hearties, yo ho.

Yo ho, yo ho, a pirate's life for me!

We're beggars and blighters, ne'er-do-well cads,
Drink up, me hearties, yo ho.
Aye, but we're loved by our mommies and dads,
Drink up, me hearties, yo ho

Yo ho, yo ho, a pirate's life for me!

Aaargh! Happy Talk Like a Pirate day, mateys!

Rolling on the River

It was the American Civil War.

In February, 1862, the city of Nashville, Tennessee, was captured by Union forces. This began one of the strangest episodes in North American military history.

Overnight Nashville was converted into a supply depot for the Union's southward moving forces. The amount of locomotive and riverboat traffic increased dramatically, as did the population of Union soldiers. Some were stationed there, others were passing through on their way to different fronts.

And prostitutes, the eternal ancillary business to military campaigns, became prevalent. An area of town called Smokey Row (named after the opium dens) featured over 70 brothels. Aside from thousands of soldiers, rumored clientele included Lincoln's future assassin John Wilkes Booth, and Lincoln's successor to the Presidency, Andrew Johnson (no link aside from coincidence has ever been uncovered).

Syphilis and gonorrhea were rampant. Soldiers and prostitutes equally became ill from diseases spread in Smokey Row.

Pvt. Franklin Bailey wrote his mother that he'd need a dictionary "to find words enough, and then I could not find them bad enough, to express my hatred of those beings calling themselves women" in Smokey Row. Later in the same letter, however, he tried his best (perhaps he borrowed a thesaurus) and wrote that they were "abominable, low, vile, mean, lewd, wanton, dissolute, licentious, vicious, immoral, and wicked."

Pvt. Bailey, however, was an exception. The general feeling of most troops was that "No man can be a soldier unless he has gone through Smokey Row"

The Union commanders were less concerned with morals than they were with military capabilities. With many of their troops hospitalized from sexually transmitted diseases, the ability to launch further military campaigns was impaired.

Punishing soldiers didn't help. Nor did medical lectures. And antibiotics were in their infancy.

Something had to be done. Since the soldiers were needed to fight the war, they couldn't leave.

And so, on July 6, 1863, General James Morgan issued "Special Order No. 29".

This order basically said that prostitutes in Nashville were to be rounded up and sent somewhere else. How and where weren't specified.

And so into the picture entered a plain 3-month-old steamboat named Idahoe and her captain/owner, John Newcomb.

Idahoe was one of many steamboats at the waterfront under charter to the army. History has not recorded why she was chosen out of the many available.

Union forces rounded up hundreds of women from Smokey Row, storming buildings and catching women who tried to jump out of windows to escape. Non-prostitutes were also inadvertently nabbed in the confusion, just from being too close to that part of town during the operation, and required family to free them.

On the morning of July 8, Capt. Newcomb was finishing his breakfast coffee on board the Idahoe, when he was assaulted by noise. As he walked to the gangplank he was met by Colonel George Spalding, who handed him an order that read, "You are hereby directed to Louisville, Kentucky with 100 passengers put on board your steamer today, allowing none to leave your boat before reaching Louisville."

Even as Newcomb read this, the ladies were being driven on board. He was given no money to buy food for them, nor guards to enforce discipline.

How many women were put on board the Idahoe is unknown. The ship was built for 100 passengers. No reliable count was taken, and the best estimate is 150-200.

The journey to Louisville was a nightmare for Newcomb. His unwanted passengers destroyed the boat's once luxurious furnishings. He had to buy ice (for fevers) and food, at his own expense. Places where he stopped for supplies put guards at the dock to keep the women from disembarking.

The prostitutes continued to ply their trade, waving at men as they went upriver, and raising their dresses to advertise. Customers rowed themselves on board for brief stays as the Idahoe chugged slowly along.

By the time he got to Louisville on July 14, word of his unusual cargo had preceded him, and local authorities refused to allow him to disembark the ladies. Instead, he was ordered to proceed to Cincinnati. Kentucky's military governor assigned several soldiers to the Idahoe to serve as guards to help enforce discipline. This quickly failed, as the men given this coveted assignment received free services from the passengers.

By the time he got to Cincinnati, of course, the local government also refused to let him unload his passengers. Newport, Kentucky, on the other side of the river, didn't want the "frail sisterhood" (as the local newspaper called them), either.

So with nowhere to go, the Idahoe anchored off Cincinnati for several days, and turned a brisk business as a floating brothel while Captain Newcomb aged rapidly. Somehow he managed to persuade the army to telegraph Washington D.C. for a decision, and the question went all the way to U.S. Secretary of War (now called Secretary of Defense) Edwin Stanton.

Stanton was managing the complex issues of a war covering half a continent and an ocean, and was likely stunned by the unusual decision that showed up on his desk that day. He came up with a direct solution: Take them back to Nashville, and deal with it.

So on August 3rd the Idahoe returned to Nashville, and it's passengers resumed their usual lifestyle. This gave the headache back to the Union commander (now General Robert Granger) who spent a few days trying to find a solution, and finally came to a very pragmatic one: he legalized prostitution.

Under the new rules, each "public woman" had to have a license ($5) but needed to pass a medical examination first. She was then required to have another exam every 10 days in order to keep her license.

The solution was a success. Suddenly the "wayward women" had a legal profession. Disease control (by the standards of the time) improved. The prostitutes now had access to medical care that they didn't have previously. The Union doctors assigned to the "Hospital for the Reception of Valetudinarian Females from the Unhealthy Purlieus of Smokey" (yes, that really is what they called it) began taking notes, and wrote some of the first detailed reports on the sociology of prostitution.

The program was such a success that physicians from other cities came to study it.

Captain Newcomb spent the next 2 years trying to get reimbursed, meeting with military officials and eventually pleading his case in Washington. Finally, on October 19, 1865, he received payment of $5316.04. This was the amount he'd been asking for from the beginning for damages, new furniture, fuel, food and medicines purchased, etc.

He had a long career on the river, but never shook off the reputation as the "captain of the floating whorehouse".

He sold the Idahoe a few years later. In 1869 she was lost in the Washita River, cause unknown.

Skool Nerse Time

This is Mrs. Grumpy. Yes, another exciting school year has begun, and I'd like to share a short play with you.


Kid walks into my office today, doing some sort of weird I-can't-hold-still dance move.

Nurse Grumpy: "What's up?"

Little kid: "My butt itches!"

Nurse Grumpy: "Have you tried scratching it?"

Kid scratches ass for 10 seconds.

Little kid: "Thanks nurse, that feels much better." (leaves my office)