By jove, I think he's got it!

Mr. Gregory: "Today is the 24th. Doctor, do you realize what that means?"

Dr. Grumpy: "Um, no?"

Mr. Gregory: "It's been 24 days since the month started."

Meetings and conferences and grand rounds OH MY!

A large part of a medical career is spent half awake in a darkened auditorium. It starts in medical school with classes. During the 3rd & 4th years it expands to include grand rounds and teaching conferences of whatever rotation you're on.

In residency it continues, with most programs having at lease 1 daily conference. Residents who don't show up risk incurring the wrath of the program director.

In the REAL WORLD this stuff continues. It's worst if you stay in academics, but even in private practice there are CME courses, annual meetings, etc. to go to (okay, I haven't gone to any for over 12 years, but I'm atypical). My idol, Dr. Oscar London, pointed out that by the time they finish training most doctors are conditioned to doze off when they hear "May I have the first slide, please."

But I digress.

Anyway, the point here is that these meetings are BORING. Except for the occasional fistfight between doctors breaking out (I personally witnessed one at a tumor board between a medical oncologist and radiation oncologist) these things are dreary as hell.

But there are rare exceptions. The one that will likely live on as THE MOST INTERESTING MEDICAL PRESENTATION EVER was in 1983, at the American Urodynamics Association annual meeting.

The presenter was Sir Giles Brindley (knighted in 1986 for bioengineering research).

At this point, I'm going to send you over to a summary article for the remarkable story of that day.

Thank you, Science Marches On Department!

Set to music, too

Dr. Grumpy: "What can I do for you?"

Mrs. Windows: "Do you have Powerpoint on your computer?"

Dr. Grumpy: "Um, yes?"

Mrs. Windows: "Here's a complete presentation on my symptoms." (hands over memory stick)

Addendum to the previous post

While reading the drunk-driving article linked in yesterday's post (below) I noticed this name in the comments under it:

If you're gonna do it, do it right

I bet he and his son are proud of each other.

Thank you, Amanda!

The surgery mindset

On rare occasions an orthopedic surgeon will rent a half-day of office space from Dr. Pissy and I, and today was one of those.

Unfortunately, the power was out for a few hours this afternoon due to the snowstorm. This is a major inconvenience, but what can you do? So the patients and I work through it as best we can.

Not the ortho doc, though. 10 minutes after it went out he came storming out of an exam room and went up to his secretary.

"Suzy! This power outage is unacceptable! Call the electric company and have them turn it back on immediately!"

Pissy and I had a hard time not cackling as he marched back into the exam room.

Awesomeness

Some days a patient reminds me of the (dwindling) reasons why I still love this job.


Dr. Grumpy: "Have you had any neck pain?"

Mr. Awesome: "I have no idea."

Dr. Grumpy: "You don't know if you have neck pain?"

Mr. Awesome: "Look, doc, I'm 89. If you pay attention to every ache and pain at my age you become a fucking hypochondriac."

Patient quote of the day

"My Dad had cancer. I think it was prosthetic cancer."

Why do I bother?

Dr. Grumpy: "Did that medicine help?"

Mr. Pill: "I don't know. The pharmacy never filled it."

Dr. Grumpy: "Whaaa..."

Mr. Pill: "I dropped it off last month, but they never called to tell me it was ready."

Dr. Grumpy: "Did you go by to get it? Or call them to ask if it was ready?"

Mr. Pill: "Was I supposed to?"

The ink is black, the page is white

Race relations are more complex than passing laws and saying "look, we elected/hired a black person." A lot of the time real change is seen at a level that politicians and activists won't even tell you about.

So here's a story that you won't hear on the news or from a politico's mouth.

I have a patient, an elderly white man. His wife died 2 years ago, and he has no kids or local siblings. In 2010 he developed a relentlessly progressive neurological disease, with increasing disability over time.

A long time ago, when he was a teenager, his parents were prominent members of the Grumpyville community. When a group of black families wanted to build a community center, the majority of Grumpyville whites fought like hell to keep them from doing so. Because, after all, they were black people.

But Mr. Patient's parents were different. They had this bizarre (for the time) view that people were equal, and should be treated fairly. So they stood up against the majority of the community, bought a parcel of land for the community center, and then financed a large part of it out of their own pockets.

So it got built. And became a successful (and still in existence) black center in Grumpyville. Years went by. Mr. Patient's parents grew old and died, and then Mr. Patient grew old and sick.

There's nobody at the community center old enough to remember how it got started. Although the center's humble origins are doubtless memorialized somewhere on a wall or booklet, most of its members are my age or younger now.

Mr. Patient is stubborn (like most guys) and been reluctant to leave the house he and his wife have owned for 50 years. To him moving into a care home was out of the question. His financial resources, though comfortable, didn't allow him to hire much in the way of outside help. And he was too stubborn to call friends for help. So he worsened, and became increasingly unable to care for his home and self.

Usually these situations end in disaster. The patient is found lying on the floor, dead or near it, after the postman notices no one is getting the mail. But this one was different.

Last month, through the community grapevine, one of the administrators of the black community center heard about white Mr. Patient, and realized who his parents were. He contacted him to offer help, and to my surprise, Mr. Patient accepted.

So now Mr. Patient is able to continue living at his house because volunteers from the community center, all born long after the place was established, come to his home a few times a week. They bring him meals and groceries, help with the upkeep of the house, and are allowing him to stay there as long as possible.

That's what real measures of human change are.

"That was the wrong button, Nigel."

"British Airways apologizes for this unfortunate incident, and will pay to wash or replace our loyal passengers' underwear."

Doctors behaving badly

Mary interrupts me with a patient. A doctor who doesn't refer to me is on the phone, and says it's urgent he talk to me.


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

Dr. Dislike: "Hi, does Fukitol interact with Noshakes?"

Dr. Grumpy: "Is one of my patients over there?"

Dr. Dislike: "No, I just want to know for someone I'm seeing tomorrow."

Dr. Grumpy: "You had me interrupted with a patient to ask me a simple drug question?"

Dr. Dislike: "I'm very busy. I don't have time for this. Answer the question!"

Dr. Grumpy: "Look it up on ePocrates." (hangs up)

Magazines at the grocery store check-out line

Sheesh. All I wanted was some hamburger buns, tomatoes, and onion rings.





Reminded me of this.

Thank you, Webhill!

Clothes make the man

Due to a laundry machine catastrophe yesterday, Local Hospital has run out of patient gowns. So they're using a bunch of promotional T-shirts they found in the basement.

As a result, my drooling, incontinent 92 year old male stroke patient, with advanced Alzheimer's disease, is wearing a T-shirt that says "I'm a proud new Daddy!"

With little baby footprints under the word "Daddy."