All right, for those of you who are too busy to keep up on breaking medical research that affects our lives, here's a big one:
The Center for Disease Control publishes a weekly report summarizing disease trends. In this week's, among generic items about flu and arthritis, was a case of Campylobacter jejuni (it's a bacterium) infection in 2 sheep-ranch hands in Wyoming.
Normally this bug is spread by contaminated food. But the 2 guys involved hadn't clearly eaten anything known to be an infectious source.
So, after diligent detective work the CDC found this pair had contracted it by castrating lambs.
WITH THEIR TEETH.
Yes, folks. These guys were actually biting off lamb balls. While this was a way of detesticulating sheep back before the germ theory was popular, it's generally fallen out of use.
Except, apparently, for 2 guys in Wyoming.
So, to summarize:
1. Animals carry diseases.
2. When neutering livestock, do not use your teeth as a surgical instrument.
3. Be careful who you kiss on a Wyoming sheep ranch, as you don't know where their mouth has been.
I've always liked the Muppets. One of my favorite songs is "Rainbow Connection," as performed by Kermit at the beginning of their first movie.
For those of you who don't know it:
Anyway, it may be corny, but the song got me through some shitty times. After I failed the first anatomy test in medical school (big time, too- I was the class low out of 120 people) I went to a used record store and bought the Muppet Movie soundtrack just to listen to that song. In a sappy sort of way it reminded me of why I was there in the first place, and I pulled my shit together, didn't drop out of school, and forged ahead.
Life goes on. Medicine is still fun. I mean, I like what I do. I have to earn a living, so I might as well be doing something I like.
And then, one day a few years back, I was having an ordinary day at the office. And toward the end of it was served with my first malpractice suit.
Nothing will kick the shit out of you faster than that moment. Yes medical students and residents, you WILL get sued. Get used to it. Someone on Sermo recently wrote "I have believed for a long time that unless you are practicing grossly negligent medicine your probability of getting sued is small." This is a remarkably ignorant statement.
Getting sued is like cancer- something that happens to other people. I think all doctors, on a superficial level, know it will likely happen. But you're still blindsided when it happens to you.
Obviously, I'm not going to go into legal details of the case, or who won, or even if it was dismissed. Because none of those are relevant to this post.
And I'm sure there are plenty of patients out there who can write how horrible Dr. Butcher maimed you. I'm sure some of you have legitimate claims. But I'm not writing about you.
Malpractice isn't black or white. It's really mostly shades of gray. I'm not biased against lawyers, in fact- my Dad is one, and sued several doctors for malpractice. But I'm not going to get involved in arguments about lawyers vs. doctors, either.
My point is just my own experience.
People portray doctors as being arrogant or uncaring. And I'm sure some are. But anytime a case goes bad, it's personally devastating for most of us. Even if you did nothing wrong. Sometimes shit happens despite your best efforts.
It hurts. A lot. You do your best day in and day out, and feel awful when things go wrong. And now someone is accusing you of having committed malpractice in your efforts. They tell you not to take it personally, but how can you not? Hell, they even name your spouse in the suit (really, they do).
You see, there is always another doctor out there willing to testify in court (for a nice fee, of course) that what you did wasn't appropriate. He's Dr. Jukebox. You put in money and he'll play whatever tune they want him to (it pays a lot better than seeing patients). The statements from these whores will make you feel like shit, and the legal language used makes you sound on a par with Dr. Mengele.
No amount of medical competence can prevent someone from filing a lawsuit against you. Even if you did nothing wrong, there's always a hungry lawyer willing to take the case. After all, it only costs about $100 to file a suit, the potential payoff is 1/3 of the winnings, and he knows a Dr. Jukebox who will gladly testify that you're incompetent.
Your medical school teachers won't tell you what it's like to be sued, but I will.
It's devastating.
It kicks the shit out of you. You lie awake at night wondering if you're going to lose everything you ever worked for. You cry. You think about suicide, but have to go on for your family. With this sword of Damocles hanging over your head, you still have to go to work every day, and do your best for the patients who still depend on you. Some days it's pretty damn hard NOT to start drinking.
And, deep down, you wonder: Am I really incompetent? You question your own judgment. Suddenly every headache patient needs a brain MRI. Every person you see is a time bomb. You start to view them as the enemy.
People use the phrase "defensive medicine" in a derogatory fashion, meaning unnecessary testing doctors order to prevent themselves from being sued. But after it's happened to you, hell, you don't give a fuck how much money the "unnecessary" tests cost. You'll order anything to cover your ass.
And no matter what you did, Dr. Jukebox will testify that it wasn't the right thing. And no amount of literature in your favor will change his "expert" (i.e. well-paid) opinion. The people on the jury deciding your fate aren't medical people.
Even if you win, it still doesn't take away the living hell you and your family are put through for the 3-5 years (yes, years) it takes the case to play out. The sleepless nights, the gray hairs, the stress eating that shortens your time on Earth, and the spouse and kids who worry about you.
And, regardless of the case's outcome, it will forever destroy your Rainbow Connection, and the beliefs that once drove you to dream of being a doctor.
Ms. Hallux: "Hi! Does Dr. Grumpy have Youtube at his office?"
Annie: "I guess so. I mean, we have internet access."
Ms. Hallux: "Okay, my toes do this weird shaky thing at night, and my boyfriend filmed them and put them on Youtube. Can your doctor look at them and tell me what it is?"
Annie: "Are you one of our patients?"
Ms. Hallux: "No, why?"
Annie: "To get the doctor's opinion you're going to have to make an appointment and come in."
Ms. Hallux: "I don't need to come in. I don't have time for that. Can't he just look at the video and tell me what it is?"
Annie: "To give an opinion he'd have to see and examine you, and get a history and..."
Ms. Hallux: "Why does every doctor's office tell me that? No wonder nobody can get proper care anymore." (click)
We all love ice cream cones, but they're a HUGE hassle. I mean, you have to turn and lick them on all sides, otherwise they drip down and get messy. And this is SUCH A BIG PROBLEM that it hardly seems worth the effort to have a cone.
But not any more!
This remarkable product continues the worldwide trend of eating more calories while expending as few as possible, so someday you too can look like the people in WALL-E. You may now experience the ultimate in human laziness, and never worry about getting ice cream on your sneakers again.
Local Hospital has been transitioning to an electronic chart system.
This morning, while on rounds, I dialed in to the hospital system to dictate a consult. I was stunned to be told that my privileges had been suspended for delinquent medical records.
This was a shock, as I treat medical records with an obsession. Every Thursday I stop by medical records and ask if there's anything for me to sign. For the last 6 weeks the girl there has politely checked her computer, then said "Nope, thank you for checking".
So I promptly marched down there:
Dr. Grumpy: "Excuse me, do I have anything to sign today?"
Ms. Helpful: (looking at her computer) "Um, nope. Thank you for checking."
Dr. Grumpy: "Well, when I dialed in, it says I've been suspended for medical records delinquency."
Ms. Helpful: "That's correct. You have over 60 charts to complete, 28 of which are delinquent"
Dr. Grumpy: "WHAT!!! Then why didn't you tell me that?!!"
Ms. Helpful: "You only asked me if you had anything to sign. You have nothing to sign. We are all electronic records now. You don't actually sign anything."
Dr. Grumpy (in shock): "Okay... So how do I complete my records?"
Ms. Helpful: "You have to log into the e-Chart system."
Dr. Grumpy: "No one told me we'd completely switched to e-Charts, or that I had records to complete. How was I supposed to know this?"
Ms. Helpful: "Because the first time you sign in to e-Charts it tells you that".
Were you a perfectly straight heterosexual until you learned to drive, and then, upon getting your license, immediately developed an uncontrollable attraction for your own sex and switched to the other team?
Did you find that handling the steering wheel all-by-yourself made you want to start wildly screwing everything in site and use porn (I think I did, but it likely had more to do with 16 year-old-boy-hormones than my 1978 Datsun 810 station wagon).
In a stunning discovery, the highest religious council of Saudi Arabia has actually discovered these "facts," with a new report warning that if Saudi woman are allowed to drive the population will turn to homosexuality, prostitution, and pornography. It also noted that within 10 years of the ban being lifted, the nation would completely run out of virgins (REALLY!).
It's December 1, the Christmakuh/Kwanzaa/Solstice/Festivus season is upon us, and it's time to roll out the annual holiday gift guide. As always, we at Grumpy Neurology, P.C. scour the internet and catalogs year-round so you don't have to!
In the past I've focused on gifts for humans, but since dogs are a big part of our families, I thought I'd kick off this year with something for them. And what better gift for a furry friend than his own sex doll?
(click to enlarge, if you're into that sort of thing)
Yes, the HotDoll doggy love toy is available in 2 sizes (looks like small and medium from the site, I don't see anything for a Great Dane), and is "made to be easily distinguished by dog’s eyes."
It also notes that "the pink hole needs to be washed regularly for hygienic reasons," a job which will likely spark more family fights than "whose turn is it to pick up the dog poop?"
I can just see this being marketed with The Rolling Stones belting out a modified version of one of their classics:
"Hey! You! Get off of my leg! Don't hang around, or sit up and beg!"
The site doesn't say if there are other models that require batteries, but quite frankly I don't want to know.
This blog is entirely for entertainment purposes. All posts about patients, or my everyday life, or anything else may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate. I could be making all this up. I may not even be a doctor. The only true statement on here is that I probably drink more Diet Coke than you do. A lot more.
Singing Foo!
Twitter fans- you can follow me @docgrumpy
Cast of Characters:
Annie: My Phenomenal MA Mary: My Awesome Secretary Ed: The office fish Dr. Pissy: The guy I share an office with Mrs. Grumpy:My Boss (also the world's greatest school nurse) Frank, Craig, and Marie:The Grumpy Tribe Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
