Failed biology, did we?

Dr. Grumpy: "Any illnesses run in your family?"

Mr. Guy: "My dad has diabetes and high blood pressure. My mom had a hysterectomy."

Dr. Grumpy: "Okay."

Mr. Guy: "Both my sisters had hysterectomies, too. Hey, does that mean I'll need one someday?"

"It's the family name, son. Try to live up to it."

I don't know what else to say. Just read it.

Thank you, Webhill!

Wednesday afternoon rant

The buzzword that's driving me nuts right now is "artisanal".

Nothing is a plain anything anymore. Stores sell artisanal breads. Restaurants advertise artisanal ravioli and artisanal sandwiches. Coffee places are pushing new artisanal blends. The word is every-fucking-where.

It makes me want to produce some artisanal vomit.

That's all.

Dear Marketing Bozos,

Thank you for this helpful sheet on things my patients should avoid to prevent migraines.






1. Head trauma. Wow! I was completely unaware that patients should avoid this. I figured it might toughen them up, and openly encouraged it. Perhaps I should rethink my opposition to seatbelts and motorcycle helmets, too.

2. Menstruation. I'll let all my lady patients know to stop doing this immediately. I had no idea it was under voluntary control, so I'm glad you told me.

3. Weather changes. I'll tell my patients to immediately move somewhere that has absolutely no weather changes. Like Pluto.*


* Actually, sometimes this doesn't sound like such a bad idea.

Oh, for hell's sake!

(I bring a new patient back to my office)

Dr. Grumpy: "Hi, ma'am, I'm Dr. Grumpy. Have a seat."

Mrs. Evil: "Pleased to meet you."

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

Mrs. Evil: "I used to see Dr. Brain, and I didn't like him. Do you know Dr. Brain?"

Dr. Grumpy: "Yes, I..."

Mrs. Evil: "Then I don't like you, either!"

(Gets up and walks out)

January 25, 1995

What were you doing on January 25, 1995?

Most of you probably don't remember. I don't, besides that I was in residency.

I bet you have no idea how close you came to dying (it was 2 minutes). Or, if you didn't die, having your life dramatically altered.

A Black Brant is a type of goose. It's also the name of a Canadian rocket routinely used for atmospheric experiments. It's launched with a bunch of instruments (depending on what's being studied) and the instruments are monitored during the flight. They then parachute back to Earth and are recovered for further data.

Black Brants are commonly used by Canada, the U.S., and several other countries for research. And so it was on this day in 1995.

A team of U.S. and Norwegian scientists launched a Black Brant from northwest Norway to study the Aurora Borealis. It contained standard scientific instruments.

But things - almost - went horribly wrong.

Routine notification of scientific and test launches is customary, and this one was no exception. 30 countries were told, including Russia. But due to layers of bureaucracy, the notice wasn't passed along their military chain. After all, the cold war had been over for 4 years.

As the rocket climbed, it was picked up by Russian radar early warning systems. It was on a trajectory that matched a predicted Trident missile launch from U.S. nuclear submarines in the Arctic circle. As it flew it also crossed an air corridor between American ballistic missile silos in North Dakota and Moscow, which resulted in Russian satellites tracking it.

The Russians read it as an American first strike. Both sides had practiced war games where a single high-altitude nuclear explosion from a submarine would be used to blind radar and satellites from the real attack, while the electromagnetic pulse would paralyze their defenses.

The Russian military went to full alert. Their ballistic missile submarines in the Arctic were all ordered to prepare for immediate launch. Silo crews on land were notified. Their targets would be the major cities of North America and western Europe. They knew the American/NATO forces would respond in kind.

The Black Brant used in this case was a 4-stage rocket. As it separated the radar pattern matched that of a ballistic missile with multiple re-entry warheads coming down, further convincing the Russians that an attack was underway.

The nuclear briefcase, with its launching codes, was brought to Russian President Boris Yeltsin. Like the Americans, the Russians use a mandatory 10 minute launch window (the time needed for a submarine-launched missile to reach either country). Yeltsin activated his nuclear keys to launch a counterattack- but waited for final verification.

At 8 minutes into the alert the rocket's course became clearer, and the Russians realized it was not incoming. With 2 minutes left before the mandatory nuclear launch time, Yeltsin deactivated the briefcase and ordered all nuclear forces off alert. The incident wasn't reported at the time.

The Black Brant rocket completed it's planned flight, landing near Spitsbergen and recovered. The scientists involved had no idea what had happened.

Did that story scare you? Then think about this: It's a single incident.

On November 9, 1979 the U.S. military was testing a radar training tape of what an incoming missile strike would look like. Unfortunately, while being tested, the tape was accidentally broadcast on screens at the American nuclear missile headquarters (NORAD).

The long range nuclear bombers in Alaska were ordered to take off to bomb Russia, while the command tried to verify the attack with other radar systems and satellites (which didn't show anything unusual). It took 6 minutes before an anonymous officer discovered the error, and the bombers were recalled.

We've all heard of Yeltsin, but have you ever heard of Stanislav Petrov? He's a retired Soviet military officer, now living in Fryazino, Russia.

In September, 1983 U.S.-Soviet relations were likely at their worst point since the Cuban Missile Crisis. To top it off, the Russians had just installed a new early-warning system.

On September 26, 1983, Petrov was the shift officer in command of the Soviet early-warning radar defenses. The system twice reported an incoming nuclear strike from North America, once with a single missile, a second time with 4.

Petrov, in a remarkably gutsy move, overrode the computer both times. He declared it an error and didn't pass the information to his superiors. His reasoning was based entirely on his gut instinct that the new system couldn't be trusted. As it turned out, he was right.

Petrov himself couldn't launch a strike. But both sides were on such a hair trigger at the time that if he'd passed the information farther up the line, most historians agree that his superiors would have assumed the worst and ordered a retaliatory attack.

You want more? During the Cuban Missile Crisis Vasili Arkhipov was First Officer on a submarine stationed in the Caribbean. His submerged boat was surrounded by American destroyers, who were trying to identify it.

The captain thought war between the U.S. and U.S.S.R. had started, and wanted to launch a nuclear torpedo. To do so required a unanimous opinion of the boat's 3 top officers. The other 2 wanted to launch, and Arkhipov refused. He argued so forcefully against doing so that the captain decided to surface, identify himself, and check with Moscow. The movie "Crimson Tide" was based on his story.

In only one incident was it actually a world leader who averted disaster. In the rest (and there are many others, read here, or over here) it was a few people (even one), considerably lower in the chain.

On this day in 1995 it was only 2 minutes. Just 120 seconds. Less time than it took you to read this.

Life on the edge is precarious.

Wow!

Dr. Grumpy: "What was your reaction to Penicillin?"

Mr. Chromatic: "It made me turn all kinds of funny colors. My wife said it was every color you see in the big Crayola box."

Public Service Announcement

Look, people- the police, paramedics, and firemen are busy enough as it is.

Calling 911 for stupid crap does not score you brownie points with ANYONE.

Especially if you do it 4 times for the same problem.

And that problem is a bad manicure.

Like this lady.

Sunday reruns

Due to an insane amount amount of kid activities today, I'm just putting up this post from 2009.


Before Viagra and it's cousins, there were other methods of waking Sheriff Woody. They're still out there, for those who have issues with Viagra.

One of them is Caverject (or Alprostadil for my pharmacy fans). This is fairly effective at getting it up for special occasions. They have to be pretty special, though, because Caverject has to be injected directly into your winkie to work. What fun.

Because it came to market before the era of direct-to-consumer celebrity advertising, we were fortunately spared TV ads featuring Eric Clapton singing (to the tune of "Cocaine"):

"If your lady is hot
Just give yourself a shot-
Caverject."

But I digress.

I have a patient who's been using Caverject for years. For whatever reason he can't use one of the newer drugs. He's kind of an aging, swinging, disco guy. In the 70's he was swinging, single, wearing gold chains, and picking up babes at the disco. In 2009 he's still swinging, still single, still wearing chains, and now picking up aging babes at the disco.

A few weeks ago he had a small stroke (he's fine now), and as a result he's now on Coumadin, a potent blood thinner. This gives new meaning to "Stayin' Alive".

So last Saturday he was out getting his boogie on and picked up Ms. Agingdiscoqueen. They went back to his place for some wild times. He shot himself up with Caverject and the fun began.

And abruptly ended. Apparently she got on top, and while she was riding the disco pony, blood began squirting out the side where he injected Caverject (thanks to Coumadin). Seeing blood flying all over those areas killed the mood fast. She ran out, and likely went home to douche with bleach.

He's been visiting me and his cardiologist today, to discuss stopping Coumadin.

Thus endeth the 70's.

Memories

It was the early 70's.

My dad has always been on the lookout for a good deal. On this day he took us to a Potluck auction. I don't know if they still have them, or what they're called now.

Basically, a moving/storage company auctions off unclaimed goods. Some of it is typical, like furniture, but the Potluck part is where they sell off big unopened packing boxes that were never picked up. So you have no idea what you're getting. Every bidder dreams of buying a forgotten box with something valuable in it.

I'd never been to an auction before. It was certainly interesting to watch and listen to. Dad bid on a few items that he didn't win. I vividly remember them dragging a large refrigerator out on stage. After the winning bid had been placed they were rolling it off for the new owner to claim, when suddenly the entire door fell off.

My parents spent time looking over the displayed boxes very carefully. Dad was particularly taken with one box. It was unusually heavy for it's size, and all bound up in tape and twine. It was, as best I remember, roughly 2-3 feet on each side. Across the top, in big letters, it said "TBC".

Anyway, at some point 2 guys carried the TBC box out, and the bidding began. Somewhere in there Dad entered the competition, and after a flurry of bidding, he'd won! My sister and I were excited, and cheered. We had no idea what had happened, except that our dad had won. The box cost $14.83 (including tax). I'd guess in today's terms it would be $50-$60.

It was HEAVY. It took both my parents and a guy pushing a dolly to get it out to the car, and I don't remember if the trunk closed all the way. We got home, and with much pushing and shoving got it into the kitchen.

Mom and Dad got out some knives and hacked their way through the heavy wrapping. We were all excited. It contained...

A Telephone Book Collection.

Yes, someone (who apparently needed a life) had collected phone directories from major cities all over the U.S.: Boston, New York, Miami, Chicago, Dallas, Seattle, Los Angeles, and many others. All neatly stacked in the box.

With quiet disappointment, the box was closed and put in the garage.

I'd forgotten all about it a few weeks later, when it was my birthday party. I had a bunch of friends over. We had the usual cake, presents, and games. And as they were getting ready to go my dad offered each kid... a phone directory.

It's been almost 40 years. I don't remember if any of them took one. Or what finally happened to the box.

Patients behaving badly

This morning I was on my usual hospital rounds, working at the nurses station. I absently noticed a patient pushing his IV pole around the hallways, writing on a notepad every now and then.

I dictated a note, moved to the next chart, reviewed some labs, scribbled a bit. The typical patient care stuff went on around me.

Suddenly, all was interrupted by someone loudly clearing his throat. "AHEM!"

We all looked up. Mr. Notepad was standing at the front counter.

Mr. Notepad: "I would like to speak to the nurse in charge."

Nurse Commander: "I'm the charge nurse today. What can I do for you?"

Mr. Notepad: "The decorative pictures in my room are not acceptable. I don't like them."

Nurse Commander: "I'm sorry."

Mr. Notepad: "I have prepared a list." (hands over a piece of paper) "I've written down the names and locations of pictures you have in the hallway that I prefer. I want to have them switched out with the ones in my room."

Long silence.

Nurse Commander: "Sir, this isn't a hotel or art museum" (hands paper back to him). If you're unhappy with the pictures, I suggest you make a donation to the hospital foundation, and send the list to them."


Mr. Notepad stomped back to his room. I went over to Nurse Commander and told her she was awesome.

Today's safety tip

DO NOT, under any circumstances, pour gasoline from open buckets and water bottles DIRECTLY into the engine of your car WHILE YOU ARE DRIVING IT!!!

Here's the story.

Thank you, Susan!

Guessing games

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

Mr. Anon: "Is he in today?"

Mary: "Excuse me?"

Mr. Anon: "Is he seeing people today?"

Mary: "Yes, can I help you?"

Mr. Anon: "I want to come in today."

Mary: "I'm sorry, but who is this?"

Mr. Anon: "I'm one of his patients and I want to see him today."

Mary: "What's your name?"

Mr. Anon: "I just want to make an appointment. If you can give me a time, I'll tell you my name."

Mary: "I can't give you an appointment unless you tell me your name."

(long pause)

Mr. Anon: "I'll just call back tomorrow." (hangs up)

Wednesday afternoon

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

Mr. Grief: "Penicillin... Doc, will this visit take long?"

Dr. Grumpy: "Maybe another 30 minutes. Do you have another appointment?"

Mr. Grief: "No, but my mom's funeral is in an hour."