Freak out!

Dr. Grumpy: "Your labs look okay, lipid levels are good, and..."

Mrs. Statin: "OH MY GOD! I HAVE LIPIDS IN MY BLOOD?!!!"

Dr. Grumpy: "Well, everyone does, and your levels are fine."

Mrs. Statin: "THAT'S HORRIBLE! I DON'T WANT ANY LIPIDS AT ALL!"

Dr. Grumpy: "But you need to understand that some levels are normal and..."

Mrs. Statin: "SO NOW YOU'RE TELLING ME THAT IT'S 'NORMAL' FOR ME TO HAVE A STROKE OR HEART ATTACK? WHAT THE HELL?"

Dr. Grumpy: "That's not what I said, ma'am, lipids are..."

Mrs. Statin: "THIS IS INSANE! I KNOW WHAT LIPIDS DO! I'M AN INTELLIGENT PERSON! I WATCH TELEVISION! I DEMAND YOU GET RID OF MY LIPIDS IMMEDIATELY! THERE ARE MEDICATIONS, AREN'T THERE?"

Dr. Grumpy: "There are drugs that are used to lower lipids when needed, but your levels are already low and..."

Mrs. Statin: "YOU'RE DANGEROUS! I'M LEAVING! I'M GOING TO FIND A DOCTOR WHO WILL TAKE CARE OF ME!!!"


And she walked out.

Flattery will get you nowhere

Part of the medical business is referring patients to other doctors, and reading their notes when/if they write back to you. Usually the letters are brief and business-like, but occasionally there's something out of the ordinary.

A few weeks ago I sent a lady to a cardiologist. I received his consult note yesterday, and saw this line. Apparently they discussed me, and he felt the need to comment on it.

I haven't changed it at all, except to take my name out.

(click to enlarge)



P.S. Dr. Ventricle: You spelled "Marx" wrong.

Attention: All my migraine patients!

Look, people, I know Botox for migraines was approved by the FDA on Friday.

This does NOT, however, mean that your crappy insurance company immediately has to cover it. Quite the contrary. Most of them will drag their feet for another 6-12 months before they're willing to cover it. So as much as you may want it, or I want to treat you with it, IT'S NOT GOING TO HAPPEN ANYTIME SOON.

So STOP CALLING. Mary and Annie logged 47 calls from Botox-seeking-patients today, all somehow under the impression that since it's now FDA approved I suddenly have an endless Bucket O' Botox and can inject it at the drop of a hat. I don't have a drive-thru window. This stuff costs $525 a bottle, so I don't keep it lying around.

I have nothing against Botox. Or migraines. But get real, people. Your insurance company moves at the speed of an arthritic snail, and in this case is actually trailing the government bureaucracy.

So relax. Your insurance will catch up with the 21st century. Hopefully before it ends.

Cultural awareness

Dr. Grumpy: "I'm glad you enjoyed your trip."

Mr. Traveler: "It was wonderful. Did you know that in the European language they call mountains "'alps'?"

Dear Local Physical Therapy

Thank you for your recent letter on my patient's progress.

I noticed that instead of writing out "exercise" your therapist used the abbreviation "ex's". It took me a minute to catch this, but it was pretty easy to figure out when I saw it used in phrases such as "strength ex's", "coordination ex's" and "home ex's program".

However, there was one part of your note where it gave me pause.

In the "treatment plan" it said "She'll be building up her arm strength using her ex's balls."

I hope (for her ex's sake) you still meant "exercise"...

"I guess that's a failing grade, huh?"

I'd like to thank my reader Toni for sending this in.

A lady in Bellevue, Washington, was arrested after she (allegedly) attacked another woman while they were attending an anger management class.

19-year-old Faribah Maradiaga "blew up out of control", whipped out a knife, stabbed the classmate multiple times in the arm and shoulder, and threatened to kill her family. She's been charged with 2nd degree assault.

To read the original article, click here.

Night at the Opera

Memories...

In medical school, my roommate Enzyme and I had a dorm apartment next to a German couple, who were both grad students. We shared one big wall with them.

This pair were into REALLY loud sex. Moaning. Screaming. And she would scream "Fuck me, Heinrich!" repeatedly, with a bizarrely musical intonation. Like an opera number.

I have nothing against sex. Or others having sex. And noise like this in a cheap apartment is part of the college experience.

But this pair could really go at it. And it drove us nuts.

It's easy to tell someone else to turn down the TV or music. It's a lot harder to say "Hey! Can you stop humping so loud?!!!"

I think the idea was Enzyme's, but after 20 years I'm not sure. I found a used classical music CD at the college bookstore, and brought it home. We were listening to it while studying when the idea began.

We set up some speakers facing the mutual wall, and waited for the Brünhilda and Heinrich show to begin one night. It didn't take long.

And then, LOUDLY, we put on Wagner's piece "Flight of the Valkyries". Although it was tricky, we were able to time the main "dah-dah-dah-DUM-dum" part to coincide with her repeatedly screaming "Fuck me, Heinrich!" It actually sounded pretty good, like some sort of operatic porn.

After the curtain went down, we turned off the music.

A few minutes later there was some loud discussion in German (likely them swearing at us).

We never heard them going at it again. I suspect they started using another room. At least then it was the other neighbor's problem.

Oooh, tell me more

Dr. Grumpy: "It looks like you have carpal tunnel syndrome. Do you do computer work?"

Miss Perky: "Yes. I work for a mens' club, handling their software, and sometimes their hardware, too".

Calgon, take me away!

This afternoon I went to pick up the kids at the after school club.

Normally the door there is open, but today it was closed. Rather than knocking, I just opened it and went in.

BIG mistake. It was closed for a reason.

I stuck my head in the door, just in time to intercept a red-paint-filled styrofoam cup with my right cheek. Followed by a kid screaming "Hey Craig! I nailed your dad!"

A paint fight (water-based paints, mercifully) had broken out, and the teenagers running the show were hopelessly outnumbered.

The kids looked like a multicolored racial variant from "Avatar".

I drove home with my (very colorful) tribe.

My car seats look like a bag of Skittles. I'll deal with them over the weekend.

All kids got thrown in the shower.

We're having an unscheduled laundry night.

Just wait until Mrs. Grumpy gets home.

Honesty

Dr. Grumpy: "Look, this is silly. I mean, this is the third consecutive visit when I told you to increase your dose, and you agree to do so, but then when you come back you tell me you never did, though can't tell my why. And you wonder why your symptoms aren't any better. If you're not going to take my advice, why do you even bother coming in?"

Mr. Pill: "Doctor, can I ask you a question?"

Dr. Grumpy: "What?"

Mr. Pill: "Do I annoy you?"

Staying active in pregnancy

Now, there are A LOT of things that a pregnant woman can do safely, but medical myths would lead you to believe otherwise. My esteemed colleague The Mother tackles the ones about pregnancy and alcohol today, and I strongly recommend reading it.

But there are some things pregnant women, especially those IN FREAKIN' LABOR, should absolutely not be doing.

Such as robbing a store.

Like this lady.

Really.


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

The 110

Actually, there were 110 of us, not 300. And we definitely didn't look anything like that.

There were 110 of us. We all met at the same time.

A few married couples. Mostly single. Most of us had just graduated from college. Several were nurses. One or two were veterinarians. An actress. Some military vets. Others had just joined the military to pay for this. 2 were Ph.D.'s in sciences. Some of us had kids. A few were even living far away from spouses and kids for 4 years just to do this.

And there we were. Most of us had just moved to this city in the last 1-2 weeks. Found apartments, grocery stores, and laundromats, and finally this building.

It was the first day of medical school.

I was a 2 day drive from home and where I'd gone to college. I'd met my roommate the week before, and didn't know anybody else.

I miss them all now. None were really close friends, but the bonds you get with people who share the same life experiences with you are incredible.

They forge quickly. Med school starts out like a sledgehammer. No matter how prepared you thought you were for it, you weren't. And everyone else was in the same boat (though most would deny it).

So for 2 years we suffered through the same schedules of tests, lab groups, STUDYING (studying is a never ending process in med school). 110 people with almost identical schedules. Your social lives also tend to mesh, because you also want to go out to relax (i.e. drink) at the same time, and have the same post-test schedules to do it on. You see each other on campus and around town.

We formed sports teams. Couples. Groups based on religious affiliation. We went to sporting events together. Movies in groups. Road trips to baseball games and amusement parks.

In the 3rd & 4th years the contacts start to break up, because we were on different clinical rotations all over town. But the last week of school there were a bunch of lectures on "what to expect in residency", and there was something oddly reassuring about being together again.

I remember all of them. It's funny, because in other circumstances many of us probably wouldn't have gotten along, but the shared experiences of medical school made us friends. I'll never forget those people. I think of them more, and remember them more, than any other group I was with. My high school class, college groups, other residents. None of them have left an imprint on my memory as strong as the 110 in my medical school class.

There's only one I'm in semi-regular contact with, because life took us both to the same hospital. On rare occasions a new patient will bring in records from out-of-state, and I note that they saw one of my former classmates. Through the miracle of the internet it's easy to see where the others landed, and it's somehow reassuring to know they're out there. I wonder if any of them look me up. I'd like to think so.

But even so...

I missed my 10 year med school reunion a while back for bullshit reasons, and still regret it. I'm definitely going when the 20th comes around.

This post was inspired by Albino Black Bear, who wrote last week about a road trip she and some medical school friends went on.

Concern

Get 15% off hospital scrubs with promo code "white_lyt1"

Mrs. Daughter: "Doctor, I'm so worried about Dad. He insists on living by himself, but he forgets to lock his doors, he loses things, he forgets to pay bills, he leaves the stove on... Can you please give us some ideas for places he might safely live? And try to talk to him into moving into one?"

Dr. Grumpy: "Of course. I'll give you a list of places you can take him to look at."

Mrs. Daughter: "Just give it to him, he can go himself. He has a car."

Dr. Grumpy: "He's still driving? You just told me he can't live alone and you're still letting him drive?"

Mrs. Daughter: "Don't stop him from driving! I don't have time to take him everywhere!"

Childhood Lesson FAIL!

When I was a kid, which was a while back, I was told to never put a plastic bag on my head. Otherwise I might suffocate.

And every bit of plastic wrapping you find today usually has a "keep away from children due to risk of suffocation" label.

But apparently, such a critical warning didn't get to everyone. Like a guy who recently tried to rob a store, and somehow ended up nearly asphyxiating himself.

Here's the article.

Thank you to my reader Sarah for sending this in.