2012 - Signs of the apocalypse

Last night I bought MS Office for the kid's new iMac. And found this review on Amazon:


(click to enlarge)

Sunday hot tub reading

A recent study showed a protein (called PZP) increases in the blood as an early sign of Alzheimer's disease. I'm not bashing this research at all, because most neurologists would love a simple, reliable, blood test to offer patients.

However, the same protein also increases in one other human condition.

Pregnancy.

And I just can't wait to tell someone "The labs show you're pregnant. Or have Alzheimer's disease. Or both."

New Year's Eve, 10:55 p.m.

"Hi, I'm a patient of Dr. Grumpy's and I need him to call in some migraine medicine. I'm at a bar, and the loud music is giving me a headache, and the DJ won't turn it down, and I don't want to leave 'cuz I already paid my cover charge."

Kids

Dr. Grumpy: "So, Marie, what would you like to do tonight for New Year's Eve?"

Marie: "Um... Have dessert?"

Saturday guest post

Today I'm featuring a post sent in by Officer Cynical.

HOW TO GO TO JAIL

1. Drive a car with really loud exhaust pipes, so I'll notice you. AND

2. Have license plates on your car that, when I run the number, come back to a completely different color, year, make and model car. AND

3. Have a suspended driver's license. AND

4. Have no insurance on your car. AND

5. Have 2 pounds of marijuana, a supply of baggies, and a scale in plain view on your back seat.

"Tell me I'm illogical! Then spank me harder!"

Because sometimes Lt. Uhura just isn't enough to get you going...

Thank you, Tab!

Games I'm not playing

Dr. Grumpy: "Okay, I'll put in the MRI order. It will take 1-2 weeks to get authorization from your insurance, then Annie will call you to schedule the test."

Mr. Oig: "Can you do it today? My insurance changes on the first."

Dr. Grumpy: "No, I'm sorry, it takes 1-2 weeks for routine studies."

Mr. Oig: "My co-pay goes from $75 for an MRI to $100."

Dr. Grumpy: "I understand, but it takes 1-2 weeks to even get it covered."

Mr. Oig: "Why don't you just order it STAT and say it's a medical emergency? You and I both know that will get it covered."

Dr. Grumpy: "But it's not an emergency. You've had these symptoms for over 2 years."

Mr. Oig: "So what? It's not a big deal."

Dr. Grumpy: "It's insurance fraud."

Mr. Oig: "Well, if you're not going to order it as STAT, then you better be willing to spot me the $25 difference."

Dr. Grumpy: "I'm not going to do that."

Mr. Oig: "Fine. Then I'm just going to find an ER that will." (leaves)

You need to have a talk with your girlfriend

Dr. Grumpy: "Are you allergic to any medications?"

Mr. Neisseria: "Um, Flaykbegon."

Dr. Grumpy: "What happens when you take Flaybegon?"

Mr. Neisseria: "Um, it, uh, well, after a few days my um, dick got all itchy and drippy."

Dr. Grumpy: "Sir, that's not an allergic reaction."

Mr. Neisseria: "Really? 'Cause my girlfriend said it was the medication that did it."

Wednesday

Dr. Grumpy: "Have you had any trouble talking?"

Mr. &%$@#!!!: "Not that I've noticed. My wife says I swear a lot, but that's nothing new."

Timing is everything

Dr. Grumpy: "What brings you in to see me today?"

Mr. Chronos: "Well, I had this really bad back pain going into my right leg after moving some furniture, and it lasted about a day, then got better."

Dr. Grumpy: "When was this?"

Mr. Chronos: "Last spring, maybe around March."

Dr. Grumpy: "So, wait... You had back pain for one day 9 months ago? And you're coming to see me now?"

Mr. Chronos: "I didn't want to forget about it."

Living legends of medicine

This post is in honor of the two best doctors in America, and possibly the world.

While their names aren't known to the general public, they're instantly recognizable to all of us in the medical profession. And, in spite of their amazing talents, neither has ever been recognized by any of the various "Best Doc" magazines published in different cities.

So I feel that, after years of them laboring in secret, it's time to honor them.

AND THE 2 BEST DOCTORS ON THE PLANET ARE:

Some Guy, M.D. and This Lady, M.D.

And here is why they so richly deserve this honor:


1. Accessibility.

I don't know either of them personally. In fact, they have no phone listing. Yet, they're far more accessible than any other doctor I know. While I only see people in my office, or the hospital, during certain hours, Drs. Guy and Lady are accessible anywhere, anytime. Patients tell me they run into them at grocery stores, beauty salons, amusement parks, laundromats, hardware stores, cocktail parties- anywhere.

I might get a little irritated (okay, a lot irritated) if patients were to corner me for a consultation while I was out with my family, but not Some Guy or This Lady! In fact, from what I've been told, they don't mind at all, and often initiate the discussions themselves!


2. Cost.

This is how I make a living. I like this job, but it's still my job. I have a family to support. So Mary has to make sure we take your insurance, collect your co-pay, etc.

But not Drs. Guy and Lady! They don't check those minor details before providing treatment! As best I can tell, they don't charge anything for their time and advice.


3. Sheer brilliance.

I, and most doctors, do physical exams and order tests. They may vary from a few labs to an MRI, but generally that's how we get an idea of what's going on, and what the best course of action will be. Not Some Guy or This Lady, though!

They appear to have an uncanny knowledge of EXACTLY what's going on with you, even though they never touch you, ask detailed questions, or order any studies whatsoever! I can only assume they must always be right, as my brief search of American medical board records showed that neither of them has ever been subject to a single complaint or lawsuit!


4. Treatments

I prescribe medications. Some are cheap, some hideously expensive. But I do it to help you.

But Drs. Guy and Lady apparently have knowledge of treatments beyond the medical realm, which they generously share free of charge, involving a number of simple over-the-counter remedies that can apparently cure anything.


5. Knowledge.

I'm a specialist. I know a lot about common things in my fields, less about rarer disorders, and only a little bit about other fields. I think most other specialists would say the same.

But this amazing pair knows about EVERYTHING. They are general practitioners extraordinaire, with a knowledge fund that puts even the greatest doctors, like Osler, Charcot, or (my personal idol) Oscar London, to shame.

I can only assume this tremendous knowledge has come from experience. Some diseases are so rare that many of us go through an entire career without seeing them, but these two have seen ALL OF IT! They have incredible connections that have led to this (usually involving their uncle's friend's second cousin's wife, who once met a lady who's sister might have had the rare disorder).


6. Trust.

There's this mysterious thing called the Doctor-Patient relationship. It involves trust, and can take a while to build. There's some chemistry in it, and conversation, and voodoo. But it's critical to helping people.

But while it can take 1 or more appointments for most doctors and patients to reach this stage, for these two it's amazingly instantaneous. Most patients who get advice from them trust them automatically and completely, and are quite confident in their diagnostic and treatment abilities. This is in spite of (or perhaps because) they don't appear to have the same, years-long, formal medical training that I and my colleagues do.


7. International reputation.

I only practice in Grumpyville, and only have one medical license. But these 2 apparently are somehow EVERWHERE. I've had patients run into them in all 50 states, and even on overseas trips. Quite frankly, hearing about them makes me embarrassed to only be able to cover 1 hospital.


So, as 2011 comes to a close, I salute these 2 giants of medicine, and their numerous contributions to patient care.

Danger: Exploding snack food!

Wow. And I thought shaking up a can of Diet Coke was dangerous.

Beware of the Dragon!

I'd like to thank Brent for sending this in. It's from a cardiologist's dictation done with Dragon, that was mailed without being proofread.

While I can understand what the doctor is trying to say, this just sounds bad, and makes him look sloppy. And the little "This dictation was done with voice recognition software and may contain errors and omissions" disclaimer (that everyone puts at the bottom these days) is just a fancy way of saying you're too damn lazy to proofread.


"Concerning symptoms are note above and the patient, who by history sounds like she has had brief episodes of PSVT. All his life. I would like to obtain an echocardiogram and if this is unremarkable. A stress echo to start her duration of the above. If these are unremarkable. We will obtain an event monitor.

He is instructed that he is not to drive a lesser correctable etiology of these spells can be found or if he does not have them for 6 months. As also instructed not to be in a situation where she has a spell. He didn't injure himself, such as being a ladder."

December 25

Today we celebrate the birthday of one of the most remarkable people in recorded history.




Sir Isaac Newton

At the age 25, he published the Principia, which laid out the laws of force, motion, and gravity. He went on to invent calculus, showed that light is made up of a spectrum of colors, and made significant advances in optics. Although others would likely have discovered these at some point, it’s truly remarkable that one incredible intellect did so much.

Therefore, Sir Isaac, in honor of your 369th birthday, I dedicate this. Without you, it couldn't have been written. And I imagine it would be even better if all the exoplanets were known when it was.