Wednesday, May 4, 2011

The Mind of a Neurologist

Between patients I'm sitting here listening to iTunes on the computer, and it picked Supertramp.

At the end of "It's Raining Again" there's a chorus of kids singing "It's raining, it's pouring, the old man is snoring. He bumped his head and went to bed and didn't get up the next morning."

And I immediately think "Huh. He must have had a subdural hematoma."

Sigh.

I've been doing this for too long.

Online learning

Last night I did some online CME (Continuing Medical Education), which featured a webinar. The speaker was discussing ways to improve patients' overall health.

One of the techniques he recommended was having them keep monthly exercises diaries, and reviewing them at each visit. He called them, logically enough, "Patient Exercise Diaries" or PED.

His suggestion was to keep older diaries in files at my office, and at each appointment compare them to a patient's most recent one. Then he put up a slide summarizing this idea:

It said "COMPARE PED-FILES AT EVERY VISIT." (try saying "PED-files" out loud).

It's a good thing they couldn't see or hear me. Because I lost it.

Tuesday, May 3, 2011

I bet you did

Dr. Grumpy: "Have you had any surgeries?"

Mr. Webster: "Yes. When I was five I had an autopsy."

More Doctor's Lounge Horrors

Coming on the heels of the Doctor's Lounge Muffin Massacre...

This morning, as usual, I started at the doctor's lounge. I grabbed some Diet Cokes and a bagel, and trundled off to see patients.

This is the bagel I randomly picked up, without paying much attention:





Later, at the nurses station, I unwrapped the bagel, to discover this:





I'd like to thank my anonymous colleague who bit/tore a hunk out of this bagel, wrapped it back up, and returned it to the tray, for helping to support my diet.

Monday, May 2, 2011

Annie says I'm causing trouble.

Mrs. Azul: "I'm allergic to everything blue. Blue paint, blue berries, pills with blue dye."

Dr. Grumpy: "You're wearing blue jeans."

Mrs. Azul: "I am? Oh, I'm color blind. I'll have to change when I get home, so I don't get a rash."

Patient quote of the day

"The pain is constant, but not all the time. It's intermittently constant."

Relativity

Last night Mary called me at home to ask a question about the week. Craig was in the room, and overheard the conversation.

After I got off the phone he came over to me.

Craig: "Dad, how old is Mary's little girl?"

Dr. Grumpy: "She'll be 5 this year."

Craig: "5! Wow! That makes me feel so old!"

Sunday, May 1, 2011

Voodoo doll

An anonymous reader says she works for a group of surgeons, and keeps this near her desk to take frustrations out on.




Having to deal with neurosurgeons, I sympathize. I thought about getting my own, but would likely destroy it after a weekend on call.

Saturday, April 30, 2011

Saturday Re-runs

Due to various amounts of family junk this weekend, I'm re-posting this from a while back.


As my regular readers know, I moonlight as a consultant for various medical market research companies. It's a thankless job, but somebody has to pay for the tomatoes.

So last night I had a dinner meeting with neurologists and sundry other specialists to review data on an up-and-coming product.

These are never fun, because neurologists by nature are a remarkably pathological group of personalities. Back when I worked at Humungous Neurology, Inc. the partners would argue if it was dark or light outside. I think they invite the other specialties to these as a buffer.

But I digress.

So I was seated next to Dr. Harangue, who I'd had the good fortune of not having seen in at least 5 years. In his own mind he's a giant in his field. To those outside his mind he's an obnoxious boil. He may have once been a good doc, but as they say in Hollywood "you're only as good as your last picture". And his was made before Casablanca.

Neurologists will argue over anything. The meal started with a dispute across from me over who's bread plate was who's (right or left? GET YOUR BREAD OFF MY PLATE!) followed by a fight over which fork is used for salad. Somebody actually dragged the maitre d' to the room to settle the issue (no, it wasn't me. I sit still and keep my mouth shut as much as possible).

I'm not much into the swanky places they have these meetings at. I ordered a steak. I had no idea how complex this was.

Waiter: "How would you like that cooked?"

Dr. Grumpy: "Medium."

Waiter: 'That involves a light red center. Is that okay?"

Dr. Grumpy: "As opposed to..."

Waiter: "Well, rare is a pink center."

Dr. Grumpy: "Medium is fine."

Waiter: "I can do medium rare, too. That's a pink/red combo".

Dr. Grumpy: "What's wrong with medium?"

Waiter: "I'll just do medium-rare-plus for you. That's a pinkish-red."

Whatever. I'm trying to order a steak, not pick out draperies.

Then the talk began. Every time a doc involved in the study was mentioned, Dr. Harangue felt the need to interrupt and say "I know that doctor personally. We've been close friends for over 25 years." By the end of the meeting I was hoping they'd mention a study done by Hippocrates or Woodrow Wilson to see if he knew them, too.

After 15 minutes of talking, the speaker stepped out from behind the podium to show us all that his zipper was down, with his tucked-in shirt hanging out of it. A tactful internist promptly yelled "Christ! Your fly is open!" to drop a subtle hint.

Then they brought dinner. The cardiologist next to me had ordered prime rib (no comment), and the waiter accidentally set my steak in front of him, and his prime rib in front of me. I pointed this out, and he quickly switched plates.

The cardiologist had a freakin' FIT! "I don't want that now! It was in front of him! He could have H1N1, or worse! Doesn't the heath department check you places anymore?!!!" It was, literally, in front of me for less than 5 seconds.

So I quietly started my steak, while they went to get Dr. Germaphobe a new prime rib (actually, I think they just brought him back the old one).

The next speaker showed us a seemingly endless series of graphs. After 20 minutes of this, she asked if anyone had any comments. Dr. Phlame at the end of the table immediately raised his hand. "Yes, I want to know why you chose red and blue as the main colors for the graphs. I think mauve and maybe yellow would be much more aesthetically pleasing. Also, I think some ruffles or curvy lines around the slide border would be nice."


This was immediately followed by Dr. Harangue chipping in "Dr. Phlame, do you live under a freaking rock? This company has been using those colors for years. But back to the data, did any of you people think to compare these results to a 1954 study by Longdead, et al?" The speaker (and everyone else there) had absolutely no clue what he was talking about, and Dr. Harangue chewed us out, as if it had just been published last week. When I looked it up, the study investigated a drug (that's no longer in use) for an unrelated condition.

Throughout this excitement the waiters kept refilling our glasses (ENDLESS DIET COKE HEAVEN!), so dysfunctional personalities were not improving with repeated doses of Burgundy and other wines.

In one discussion, to argue a point about a competing drug, an internist actually reached into his pocket and pulled out a product insert. I swear! He had it with him, all scrunched up. After reading from it like it was a bible he sat down and began arguing with a pulmonary doc about when daylight savings time starts.


We made it through another 15 minutes of polite discussion before Dr. Germaphobe cardiologist began tapping my shoulder. "Hey, Ibee!"

I turned around "What's up?"

"Are you gonna finish your roll?"

Stunned, I looked at the bread roll I'd absently left on my plate. It was buttered, and I'd taken a few bites out of it. "Uh, no, I'm full".

"Thanks!" And he grabbed it. So the guy who'd refused to eat an untouched steak was now chomping on my partially eaten dinner roll. Amazing what a bottomless glass of wine will do.

As we sat through another set of slides, Dr. Harangue's cell phone rang. He answered it, speaking loudly enough to be heard in the next county (i.e., his usual volume). "What? Yeah. No, I've got another half hour of this shit. The drug company people won't shut up."

The dinner ended 20 minutes later. To make sure all points were covered, the moderator specifically asked "Dr. Harangue, are there any other comments?"

No answer. It was the only time he'd been quiet all night. He was in a burgundy stupor, slumped face down next to his creme bruleƩ. He was still there when I collected my paycheck and left.

Friday, April 29, 2011

Crime in America

Words fail me.

Just read it.

Thank you, Deborah!

Highway safety

Dr. Grumpy: "What do you do when you feel a migraine coming on?"

Mrs. Hazard: "Exercise helps. I do some stretching and jog in place for a few minutes, and this keeps it from getting worse."

Dr. Grumpy: "Okay, so..."

Mrs. Hazard: "And I need a note from you to get me out of this." (pulls out papers).

Dr. Grumpy: "What is this?"

Mrs. Hazard: "It's a traffic ticket."

Dr. Grumpy: "I see that..."

Mrs. Hazard: "I was driving on the freeway and felt a migraine coming. It was rush hour, I didn't know when I'd get home, and the road shoulder was closed for construction. So I stopped in my lane so I could get out and jog in place next to the car, and this highway patrolman gave me a ticket. I don't get it, either, because I'd turned on my hazard lights. The other lane was open, so it wasn't like I was completely blocking traffic."

Thursday, April 28, 2011

Random dialing?

My cell phone rings. It's the hospital ID.

Dr. Grumpy: "This is Dr. Grumpy."

Dr. Noclue: "Hi, I'm the hospitalist taking care of Mrs. Lois Lane, and I need to refer her to you, for outpatient follow-up."

Dr. Grumpy: "Okay, how can I help?"

Dr. Noclue: "Do you take Major Illness Insurance?"

Dr. Grumpy: "Yes."

Dr. Noclue: "Okay, I will give her your number and have her see you in a week. One more question, if I may."

Dr. Grumpy: "Sure."

Dr. Noclue: "What is your specialty?"

Wednesday, April 27, 2011

Amazing coincidence

Dr. Grumpy: "Are you and your brother fraternal or identical twins?"

Mr. Gemini: "Ummm, we're the kind where we both have the same parents."

Mary's desk, April 26, 2011

A new patient filled out our info sheet, with his address and phone number, then handed it back to Mary.

Mr. Patient: "Can you copy that for me?"

Mary: "Excuse me?"

Mr. Patient: 'I want a copy for my own records."

Mary: "Sure... But all it has is your own address and phone number. You just filled it out yourself."

Mr. Patient: "I want a copy of it. I know how you people work."
 
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