Monday morning hospital consult

Never a good sign when the admitting physician's note begins:

"23 year old male, who suffered a head injury while inebriated. He was at a bar, and bit a stripper on the thigh..."

Achievement

With the school year over, Frank and Craig were comparing their Boy Scout award badges. Here are a few:

(click to enlarge)




Yes, folks, the Boy Scouts are now officially awarding an achievement badge for playing videogames.

Memories...

It's not uncommon for realistic families to allow stricken loved ones to die. Sometimes it involves taking them off machines, at others it just means stopping medications.

Years ago I had an older gentleman who'd had a massive stroke, and the family didn't want to have anything done. As always, the question of "how long will he go on?" came up, which is very hard to predict.

Because of the size of the stroke, and him developing brainstem herniation, I guessed about 24-48 hours.

Literally, before I'd finished THAT VERY sentence, he collapsed over to his right and the monitor went flat.

The daughter looked at me, stunned.

All I could say was "And sometimes it's sooner."

Fear

Dr. Grumpy: "Hi, are you the hospitalist seeing my patient, Mrs. Felldown?"

Dr. Hospital: "Yes. I'm sending her to rehab today."

Dr. Grumpy: "Did her tests look okay?"

Dr. Hospital: "I don't know. Do you? I'm busy today."

Dr. Grumpy: "This is Mrs. Felldown we're talking about, right?"

Dr. Hospital: "Yes. What was she admitted for, anyway?"

Dr. Grumpy: "She had a fall."

Dr. Hospital: "Okay. Anyway, I'm going to send her to rehab."

Dr. Grumpy: "Have you seen her yet?"

Dr. Hospital: "No, but the nurse told me she looks fine, and slept well last night."

Dr. Grumpy: "Do me a favor, can you hold her until I can come over and check her out myself?"

Dr. Hospital: "Okay."

QID TMI

Dr. Grumpy: "Any other neurological issues you want me to know about?"

Mr. Fiber: "I have bowel movements 4 times a day, and have since childhood. No more, no less."

Do not try this at home

There are several ways to remove warts.

A shotgun is not one of them.

Voyeurism and IT

Okay, people, let's think about this:

1. Electronics and water generally don't mix. High levels of humidity are NOT good for most computers.

2. I'm not sure which is more impressive: the guy's initiative, or his victim's gullibility quotient.

3. If you are that desperate to see pictures of nude women, it's not like there aren't a lot of those pics available for free on the internet these days (uh, I mean, that's what I've heard).

4. Biola, in case you've never heard of it, is the Bible Institute of Los Angeles, which bills itself as an evangelical Christian school.

And these disparate threads come together in this article.

Public Service Announcement

Attention patients:

There are reasons the hospital asks you to put your cell phone on quiet mode when visiting patients.

For example, it is disruptive to a somber family meeting on withdrawing grandma from life support when your phone rings loudly.

Especially when your ring tone is a female voice screaming "Fuck me! Fuck me harder!".

Thank you.

Signs of the Apocalypse

Because, ya know, the world REALLY needed a pizza that's perfect for when it's late at night and you and your buddies are wasted from drinking too much microbrew and you need something to line your stomachs while you watch subtitled art-house flicks on DVD.

Hospital rounds

I'm sitting at the nurses station, scribbling in a chart. Two nurses walk by, talking.

Nurse 1: "So I woke up this morning, and I'm still bleeding. I need to call my GYN back, because... Oh! Here's Dr. Grumpy! Hey, doc, I have a problem, let me ask you..."

Dr. Grumpy: "Hey! I'm a neurologist! I don't deal with that end!"

Nurse 1: "I just wanted to know if we could give Mr. Carotid sedation for his MRI. He's claustrophobic."

Accuracy in biological nomenclature

When assaulting someone with a dead animal that you randomly found lying in the road, it's always important to know exactly what species you are armed with.

Thank you, JoAnna!

Human nature

Mrs. Marlboro: "What can I do to prevent having another stroke?"

Dr. Grumpy: "Quit smoking. You also need to start taking your medications as prescribed."

Mrs. Marlboro: "That's a lot of work. Can't I just take a vitamin or something?"

Sunday reruns

Thank you for coming in on this lovely Friday afternoon, ma'am. I guess you called around 1:30 today, and since we didn't have a 4:00, which is my last slot of the day, Mary put you in. Let me just open another Diet Coke, and we'll get started.

So you've had headaches for the past 20 years? And never seen a doctor before for them? What made you come in today, of all days, for this? Oh, you did a Google search.

Thank you for this printout of all the horrible types of brain tumors and aneurysms that can cause headaches and kill people. I appreciate it, because as a board certified neurologist with over 10 years of experience I really have no idea what sorts of things can cause headaches.

If you'd read it you might have noticed that the average survival from these awful things is 1-2 years, not 20. But I'm sure you're busy and didn't have time to actually read the articles you were printing up. After all, you had your hands full calling every neurologist on your insurance plan trying to find one who still had openings on this lovely Friday afternoon.

Of course we can get an MRI. I understand it would make you feel better, and allows me to cover my own legal butt, too.

Oh, you're claustrophobic? No, an MRI is really the best test we have right now for evaluating this sort of thing. I'm sorry that Reader's Digest somehow gave you the impression that I had a gadget in my office I could wave over you to make sure everything is okay, but I don't. Dr. McCoy borrowed my tricorder a while back and hasn't returned it yet. But we can do the MRI with Valium to relax you, if such a thing is possible.

I'll have my staff schedule the test for next week. No, I'm sorry. It's now 4:00 on a lovely Friday afternoon. Your insurance company requires an MRI request to be approved by a panel of dart-throwing chimpanzees before agreeing to pay for one. All of their offices are in another time zone, and have closed by now on this lovely Friday afternoon.

You really feel you need it immediately? Then the only thing I could suggest would be to go to an ER, and tell them you need an MRI right now. I'm sure, that after hearing your story and realizing how urgent this is, as opposed to a guy with chest pain, the ER doc will be happy to waste spend time and money on your case. Just don't tell him that I'm your doctor.

Oh, I had no idea your ER co-pay was so high. $50 does seem a bit extravagant for a lady with diamond rings on every finger and Porsche keys hanging out of your LV purse. I certainly can understand your refusal to go there.

Then it will have to be next week. My staff will call your insurance first thing Monday morning to get this authorized and scheduled.

Your insurance coverage runs out at the end of this month? My calender shows that today, May 29, is a Friday (which is a lovely afternoon by the way) and the last workday of the month. So Monday will be June, and we won't be able to get the MRI from your current insurance then, since it will have run out.

What insurance will you have on Monday? I'm sorry, I'm not contracted with that plan. I can send your internist a letter asking him to order the MRI. Oh, he's not contracted with it either. I see.

Yes ma'am, I agree it was entirely unreasonable of Mary to not have foreseen that you'd be changing to an insurance I don't take next week. You didn't mention that to her when you called for this appointment a few hours ago, but she really should have known, anyway. I'll discuss her suboptimal psychic powers with her at her next job evaluation in 2018.

I'm sorry you have to go already. Well, try to take it easy over the weekend, and I'll send my records to a neurologist on your next insurance, so they can help you out.

Going to a hockey game tonight sounds like fun, and it's great that you have such good seats. That looks like a nice air horn in your purse. I'm sure that sort of quiet, relaxed environment will help improve your headaches in the meantime. Thank you for sharing this lovely Friday afternoon with me.

WTF?

My wife bought this recently. It makes no sense to me.

It's like saying "Denver-style Texas BBQ." Or "Seattle-style New York Cheesecake."