Affirmation

Mr. Radic: "Do you think my symptoms are coming from my heart?"

Dr. Grumpy: "No."

Mr. Radic: "Good. I've seen 3 cardiologists for it, and they didn't think so, either."

Breaking Artisanal News!!!

We now take you to Victoria, British Columbia to answer this age-old question:

"Where do I put the artisanal wine and beer after I've run it through my kidneys?"

Victoria has taken the lead on other cities in North America by introducing...

(drumroll, please)

AN ARTISANAL PUBLIC URINAL!!!

(at a cost of $60,000 to build, I should put processed Diet Coke in it at my next visit, just for the experience).

Dear Chester County Health Department,

I must say, your recent press release gave my inner adolescent some serious giggles.

(click to enlarge)




In doing further research I learned that the wild beaver attacked a man who was out fishing. I can only assume he was quite surprised to be assaulted in such fashion. He is reportedly doing fine at this time.

How can I help you?

As my regular readers know, I hate going to Walmart. I'm afraid of ending up on People of Walmart. I've actually seen some of my patients on the site (REALLY!).

But, yesterday afternoon, Mrs. Grumpy stopped at one because it was on the way home, and since it was Mother's day I didn't want to argue.

So we go in, and (of course) one of my Alzheimer's patients is working as the entrance greeter. His wife is also there, keeping an eye on him.

Mr. Cognex: "Hi! Welcome to Walmart!"

Dr. Grumpy: "Hi."

Mrs. Cognex: "Oh, it's Dr. Grumpy, honey! You remember him?"

Dr. Grumpy: "Hi, Mrs. Cognex."

Mr. Cognex: (looks at me): "Oh, do you see Dr. Grumpy?"

Mrs. Cognex: "No, honey, you see Dr. Grumpy."

Mr. Cognex: "Who's Dr. Grumpy?"

Mrs. Cognex: "This gentleman is Dr. Grumpy."

Dr. Grumpy: "Hi."

Mr. Cognex: "Welcome to Walmart! Are you on your way to see Dr. Grumpy now?"

Mrs. Cognex: "Enjoy shopping at Walmart, Dr. Grumpy."

Dr. Grumpy: "Thank you."

Mr. Cognex: "Nice meeting you. Maybe I'll see you at the doctor's. Welcome to Walmart!"

Maybe now my wife will understand...

Playing 20 questions on Sunday morning

Dr. Grumpy: "Okay, I'll call in a refill right now. What's your pharmacy's phone number?"

Mr. Callmeonsunday: "I don't know. What is it?"

Memories...

My first rotation as a 3rd year medical student (determined randomly at my school) was psychiatry.

Your first day on clinical rotations you never know what to expect. I was assigned to evaluate Mr. Binford, who'd been picked up by police (for vandalism) the night before.

I sat down and nervously spoke to Mr. Binford. He was a bit disheveled, but seemed intelligent and reasonable. He owned a home improvement company. He employed several handymen (including himself) and had a central dispatch office. They did all ranges of home and yard work.

It all sounded pretty reasonable to me. So, being young and naive, I presented the case to my attending psychiatrist. When he asked me what I thought, I told him that this person didn't seem to need psychiatric care.

Then he asked me if I'd read through his past chart. Sheepishly I admitted I hadn't, because I'd been in a hurry to interview the patient early on my first day.

So he handed me the chart.

OMG

The patient owned no such business. He had a remarkably intricate delusional system.

He owned a truck full of power tools, paint, and various other home repair supplies. Of which he had some knowledge about using them.

He drove around the city, day and night, and would randomly stop at houses where he thought they'd called him for work.

People would come home (or be woken up at night) to find him doing unneeded work on their houses. Cutting down trees. Painting their outside walls. Knocking holes for windows in their homes. Taking apart pool filters. In one case he'd actually painted a guy's car with house paint.

I learned that old charts were useful.

I also learned that even the incredibly delusional could make a lot of sense when you didn't know their background.

We called him "Psycho Home Repairman".

And to this day, if one of our neighbors turns on a lawnmower or other loud equipment after dark, I go to the window... Just to make sure.

Crime fighting apps

Okay, crooks, when planning to rob a place, it is generally NOT a good idea to accidentally call the cops so they can listen to you make plans.

Like these guys.

Thank you, Sarah!

Lost & Found

While reading another doctor's office note this morning I found this line:

"Vital signs were taken and documented somewhere in the chart. I have no idea where."

Annie's desk, May 5, 2011

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

Mrs. Seeker: "Yeah, my husband sees Dr. Grumpy, and knows a lot about his case."

Annie: "Okay, let me open his chart... What can I do for you?"

Mrs. Seeker: "Where do you think he'd have put our car title? I can't find it anywhere."

Wild times

SEX!

DRUGS!

EXPENSIVE CARS!

OLDER MAN!

YOUNGER WOMAN!

AND A 6 HOUR SEXUAL MARATHON!

Is it a typical day at the Playboy Mansion?

Nope. Just an Endocrinologist and his P.A.

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.

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.