Tuesday, March 15, 2011

Miracles of modern technology

Dear Dr. Hitech,

I think it's great that you recently felt the need to shell out a fortune for FUBARMED, the new computerized chart system that runs your office.

Apparently FUBARMED has a feature that lets you list me, or any other doctor, as a "consultant" in a patient's chart. I assume the idea here is to improve physician communication.

It seems like an absolutely great idea. You order an MRI, or labs, and your computer automatically faxes the results to my office, too.

In theory, that sounds nice.

But FUBARMED has no fucking clue what different doctors care about.

So it faxes me EVERY DAMN THING. Mrs. Patient (who I'm seeing for migraines) gets a pap smear? I get the results. She calls you with a runny nose? The phone note shows up on my fax machine (along with your delightful response "what color is her mucus?"). She needs a refill on her cholesterol medication? FUBARMED faxes me a notification, then a copy of your approval.

As far as I can tell, this great program of yours is functioning primarily to waste my time, paper, and fax machine toner.

Hoping to see one come over soon that says "Patient doesn't like Dr. Grumpy, wants you to take him off the consultant list."

Yours truly,

Ibee Grumpy, M.D.

Monday, March 14, 2011

Sunday Funday

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mrs. Frantic: "Help! You see my mom for Alzheimer's disease, and she's completely out of control. She's walking around the house all day and night, and yelling constantly!"

Dr. Grumpy: "At her visit last week I gave you a script for Calmherdown for this problem."

Mrs. Frantic: "Yeah! It's in the medicine cabinet!"

Dr. Grumpy: "Did it help?"

Mrs. Frantic: "Oh, was I supposed to give it to her? I thought it was for me, to sleep through this!"

Sunday, March 13, 2011

Weekend reading

While catching up on journals yesterday I learned that:

Some people's headaches will get better with Ibuprofen. Others won't. (Neurology Reviews, November, 2010, page 4).

Alzheimer's patients who are unable to care for their own needs are more likely to be placed in a nursing home than those who are still able to do so. (Neurology Reviews, November, 2010, page 10).

Parkinson's patients who are OLDER at time of disease onset won't live as long as people who are younger (Neurology Reviews, October, 2010, page 5).

Saturday, March 12, 2011

March 12, 1944




It happened during World War II. But it isn't a war story.

It's about a basketball game. But it's not a sports story.

It involved medical students. But it's not a medical story.

It was 1944.

The Duke University Blue Devils had won the Southern Conference basketball championship. Surprisingly, though, the official university team wasn't even the best one on campus.

The military had set up wartime training programs at Duke, and brought in young men from all over the country. Many were good college players in their own right, but their schools had closed down athletic programs due to the war. So when they came to Duke they formed intramural teams.

The medical school team was considered, by far, the best (possibly the last time in human history that will be said). The players had all been stars at their previous schools. Although they never played each other, it was generally thought that the medical school team was better than the Blue Devils themselves.

It had also been a good year for another local basketball team, the Eagles of the North Carolina College for Negroes. Their coach ran an aggressive high-speed game, and they'd only lost once all season. But that was how it ended. Neither of the basketball tournaments (NCAA and NIT) allowed black colleges to participate.

The details on how it started are lost to history, but somewhere, somehow, the idea came to have the invincible Duke medical students meet the NCCN team on the basketball court.

In 1944 North Carolina this was unthinkable. It was actually a crime, and color lines were enforced. A few months earlier a black American soldier had been killed by a white bus driver for not moving to the back of a city bus fast enough (the driver was found not guilty).

Coach John McLendon of the Eagles liked the idea, and contacted his counterpart at the medical school. The white team was shocked. Such a thing was unheard of, illegal, and seemed to be just asking for trouble. But eventually their pride won, and they agreed to the game. As medical student player David Hubbell said, "We thought we could whup 'em."

The game would have to be played at the NCCN gym, because there was no way to get black students onto the Duke campus without drawing attention. They'd have a referee, but no spectators would be allowed. They'd play on a Sunday morning, when most of the town (and hopefully police) would be in bed or church. The doors to the gym would be locked as soon as all the players were inside, to keep anyone from seeing what was happening. Neither school administration was aware.

The medical students drove to NCCN with a winding route, to keep from being followed. They wore hats, and had their jackets pulled up partly over their heads to keep their skin color hidden.

Inside, the Eagles were very nervous. Aubrey Stanley (who was 16 years old at the time) later said "I had never played against a white person before, and I was a little shaky."

The game got off to a nervous start, with both sides making mistakes and missing easy shots. But they soon got into their routine. Duke went to their strong half-court game, and the Eagles played their speed attack. Stanley recalled "About midway through the first half, I suddenly realized, 'Hey we can beat these guys. They aren't supermen, they're just like us.' "

The second half was a blow-out, with the Eagles scoring almost every time they had the ball. Duke wasn't accustomed to their aggressive, high-speed, full-court game, the likes of which wouldn't be seen in the NBA for another 20-30 years.

The final score was NCCN 88, Duke Medical 44. Not even close.

And then, after the 2 teams had rested, the unthinkable happened: They played again, this time a mixed game, shirts vs. skins. Black and white on the same teams. A serious violation of state law.

A few NCCN students walking by the gym heard noise inside, looked in the windows, and saw this unthinkable match-up. Nobody called the police. It was amazing to watch.

Neither game ever happened by official records. There was no scorecard. Only the player's memories.

Jack Burgess was a Duke player. He was from Montana, and a few days after the game wrote to his family "we played basketball against a Negro college team... and we sure had fun and I especially had a good time, for most of the fellows playing with me were Southerners. When the evening was over, most of them had changed their views quite a lot."

In being able to tell this remarkable story, I (and all of us) owe a great deal of thanks to writer Scott Ellsworth. Without his determined research in chasing it down, it would have been lost to history.

Friday, March 11, 2011

Skool Nerse Time

This is Mrs. Grumpy.

Dear Principal Skinner,

I think it's an interesting project idea to have each 4th grade class develop their own identity. Like flags, secret codes, and secret claps. I understand this is a 2 week project, this week with students developing their own "countries" and next week sharing their ideas with other classes.

But I think you could have ended your talk better than with the line "Next week you'll visit other classrooms to share your clap with them."

And you wondered why the teachers in back began snickering.

Thursday, March 10, 2011

Mary, bring me a Diet Coke. With rum.

Dr. Grumpy: "Anything going on at home?"

Mrs. Bright: "Just a lot of stress. My husband told me this morning he has a computer virus. I hope my daughter doesn't get it, because she's already missed 5 school days out sick this quarter."

Insurance Company Follies

I'd like to thank Kalie, who sent in this letter she saw from an insurance company.


(click to enlarge)


Wednesday, March 9, 2011

Mary's Desk, March 9, 2011

Guy walks in, stands at counter.

Mr. Tardy: "I have an appointment today with Dr. Grumpy."

Mary: "Sir, your appointment was at 10:00, over an hour ago. We have you listed as a no-show."

Mr. Tardy: "I spoke to you this morning, and you said to be here by 10:00, and I told you I'd try."

Mary: "Yes, but you're here at 11:15. I can reschedule you for later this week..."

Mr. Tardy: "Why can't you see me today? Traffic was bad."

Mary: "I understand that, but we're booked solid, and..."

Mr. Tardy: "When I called earlier you didn't even mention that traffic would be a mess today."

Mary: "Sir, I didn't know, but I did tell you to allow extra time."

Mr. Tardy: "This is bullshit. You don't have the courtesy to warn me about traffic conditions, and now you tell me it's MY fault that I'm late. I'm going elsewhere."

Today's fashion tip

If you're getting a haircut, and suddenly find yourself in need of a weapon, I can understand that the scissors being used by the stylist may be the closest thing at hand.

HOWEVER, after you're done stabbing someone with them, it's always important to complete your haircut.

Otherwise you run the risk of having a seriously bad hair day when the police take your mug shot.

Like this guy.

Thank you, Kathryn!

Tuesday, March 8, 2011

Timing is everything

Dr. Grumpy: "Hi, I'm Dr. Grumpy."

Patient: "Hello, I'm Lisa Pine."

Dr. Grumpy: "Are you related to Dr. Pine, the oncologist?"

Patient: "No, but I see a lot of his patients."

Dr. Grumpy: "Oh, are you also a doctor?"

Patient: "No, I'm a mortician."

Mickey? Can you hear me now?

This headline is on the cover of this week's Neurology Today:

(click to enlarge)




Tinnitus is subjective, and I'm not sure I understand the article's explanation for measuring this. How do you know if a rat hears a ringing in his ears? How do you ask the rat if the ringing does (or doesn't) stop? How do you know if the ringing bothers the rat? How do you know this, Sam I am?

But, then again, I'm not a researcher. Not in a lab, or with a hat, or on a cab, or with a rat.

Monday, March 7, 2011

Pointless link

Normally I don't link to the Onion. I like their stuff, but figure they get enough readers without me. Besides, it's not like they even know I exist.

But, from both a medical and human viewpoint, this article is too damn funny not to share.

Actually, it sounds like one of my patients.

Patient quote of the day

"It looked awful! I had bruising around all of my eyes and noses!"

Monday morning, 3:59 a.m.

"Hi! I need to make an appointment to see Dr. Grumpy! My brain is constantly sizzling and the government put a tattoo on my forehead to make people think I'm crazy and the FBI keeps breaking into my house every night to rearrange my shoes and poison me! I need the doctor's help so I can go to the news and tell them this! People need to know that government agents are secretly spraying acid into their ears to eat their brains away and that it will make everything smell like bacon!"
 
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