Probably me, someday

Mrs. Carehome: "A friend of mine is a doctor, and he wrote down some questions for you about my condition."

(hands over a folded piece of paper)

Dr. Grumpy: "Ma'am, this makes no sense. It's just a random jumble of words and letters, and they don't relate to anything. Are you sure your friend is a doctor?"

Mrs. Carehome: "The nurse said he used to be. We both live over at Shady Hills, though he's in the Alzheimer's unit."

Neat trick

Dr. Grumpy: "What do you do when the hand goes numb?"

Mr. Palmer: "I take out my neck and adjust it."

Things that make me grumpy

Doctor Grumpy's vote is worthless every 4 years.

That doesn't mean I don't vote for President- I always do. And almost every other election that comes up.

Every political system has it's quirks. And this one is a real pet peeve of mine.

To give some background for my non-U.S. readers:

The American political system started, like most, in an era when horses were the main method of transportation, and hence long-distance communication of news. So it wasn't practical to count every single nationwide vote in Presidential elections every 4 years (there were other issues for the electoral college, but I'll let commentators fill those in).

Each U.S. state was given a certain number of votes in an electoral college, based on how many congressional representatives it has. In this system, whichever candidate gets > 50% of the vote in a state gets ALL that state's electoral college votes. It's all-or-nothing. To be fair, a few states have tried to remedy this, by splitting up electoral votes by districts, or based on percentages of popular votes. But for most, it's still all-or-nothing.

So 3 times in American history the winner of a Presidential election was NOT the person who won the majority of the popular vote.

Now, in an era where you had to tabulate votes locally, and send the results by horseback, this system made sense. But with the invention of the telegraph, and then the radio, telephone, and internet, it's not needed. The technology is now there to count every vote, which certainly would be fairer.

So, since Dr. Grumpy lives in a state where he's in the political minority, his Presidential vote is meaningless. All my state's electoral votes go to the other side.

The practical result of this is that, out of the 50 U.S. states, only 10 or so really are the ones that elect a President. They call them "swing states", where they have a large number of electoral votes AND a population that's fairly evenly split. And so politicians only focus on kissing ass in those areas, and ignore the other 80% of us.

Now, most Americans hate this crap. Polls taken regularly since 1944 have shown that a large majority of Americans want to toss the electoral college and just go to direct election by popular vote.

Has this ever even come close to happening? Hell no. Why not, you ask?

Because it's not in the best interest of any major political party!

Let's look at this: Say I'm Humungous Political Party, trying to get my bozo elected. I have a finite amount of money to blow on TV ads, public rallies, etc. Say, (for simplicity) it's $100.

In the current system I can focus that $100 on the 10 states where it matters (at $10/state), and ignore the rest of the voting peons all over the country.

But, if the electoral college were gone, then every single vote, from populous New York to rural Alaska, becomes equal. I'd have to spread my resources thin and blow only $2/state trying to reach everyone with a ballot.

No political party wants to do that. They want to focus their dollars on a concentrated area, getting the most returns for their spending.

You can write to your congressman all you want. He'll agree with you, then vote the opposite way. Multiple attempts to change this have been introduced, and all were killed off early.

After all, voting equality is so un-democratic and un-American.

Bring me Haldol STAT! Oh, and a banana.

What do the CIA, Elvis, a former President, and orangutans have in common?

This guy, apparently.

Thank you, Tanya!

Patient quote of the day

"Doctor, I really want to know if I have something. Because if it's anything, it would probably be something. And I want to know if it's something. If it's nothing, then that's not anything, but I need to know if it's anything like something or nothing."

Jerry Springer meets Dr. Grumpy

Sermo is one of many online medical communities. I tried it a few years back, but deleted my membership out of boredom. I'd never written any posts, and got tired of the daily emails on such controversial topics as "doctors should provide patient care," "we all want to make more money," and "hospitals are for sick people."

Anyway, apparently they've livened things up (or it was online sweeps week) because my reader Sally sent in this headline, which was a "Sermo Pick" last week (on Valentine's Day, no less):

(click to enlarge)





This was, actually, a tragic story. A married doctor (Hyo Shin, age 64) had been having an 18-month affair with Sarah Garibay (age 29) a lady he met at a strip bar, and became her "sugar daddy". He died after her other sugar daddy (Jeff Clay, age 49) walked in on them at an inopportune time and beat Dr. Shin. The doctor then jumped out a window to escape, and eventually died from his injuries. Clay has been sentenced to 12 years for voluntary manslaughter.

In a surprising twist, the late Dr. Shin's wife told the court that her husband had "a high moral standard and would not stand for one speck of immorality."

The wife of the convicted Mr. Clay testified that he was "hard-working and non-violent", and that she still wanted him to come back to her even though he'd been seeing 2 other women and using methamphetamine.

Another story noted that Miss Garibay (who denied being a prostitute) testified in court while "wearing a short skirt and low-cut top." She said she "immensely" loved her married boyfriend Clay, and was "hurt" that he subsequently tried to hire a prison inmate to kill her, too.

Anyway, I asked some of my colleagues about their takes on this story, and they had a few pointers:

1. Don't date people you meet at a strip bar.

2. If you do, let the buyer beware.

3. At 64 you should know better.

4. Avoid sugar daddies on meth.

5. There are worse obituaries to have, but not many.

6. Isn't there anything better to do in Yuba City?

Nice haircut, though

Look: Even if you're in a wheelchair, that doesn't give you a license to be a crook.

And if you're going to rob a convenience store, at least have a decent getaway plan.

Thank you, Don!

We have a winner!

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mr. Florida: "Yeah, I'm a patient of Dr. Cortex, and I left my medicine back in Grumpyville. I'm visiting family in Orlando."

Dr. Grumpy: "Okay, do you have a pharmacy number there?"

Mr. Florida: "Um, no. Do you recommend any pharmacies near my hotel?"

Dr. Grumpy: "Sir, I have no idea what's there. Why don't you look around the area you're in, or ask someone at the hotel desk?"

Mr. Florida: "Am I allowed to do that?"

Dr. Grumpy: "Yes."

Mr. Florida: "Do you know what medications I'm on?"

Dr. Grumpy: "You mean you don't?"

Mr. Florida: "I told you, I left the bottle at home. I think it was in milligrams. Does that help?"

Dr. Grumpy: "Do you have a way of looking them up?"

Mr. Florida: "Of course. I keep them all on my iPhone."

Dr. Grumpy: "Where is that?"

Mr. Florida: "In my hand. I'm talking on it."

Guest post from Officer Cynical

Today, February 19, 2012, marks the 67th anniversary of the Marines' landing on the island of Iwo Jima. 70,000 U.S. Marines and support troops went ashore against 22,060 entrenched Japanese.

On March 26, 1945, when the island was declared secured, 6,812 Americans (10%) were dead or missing, and an additional 19,217 (27%) had been wounded. Of the defending Japanese force, only 217 were captured. The remaining 21,844 (99%) were killed.

27 Medals of Honor were awarded (13 posthumously) - over one-fourth of all the MOHs awarded to Marines in all of WWII.

I recently had the honor of meeting an Iwo Jima survivor at an assisted living facility. He summed it up this way: "The Japs would not surrender. They wouldn't come out of their caves. So, we burned them out with our flamethrowers, then shot them with our rifles. It was awful".

The picture I've included is not the one you might expect - the flag-raising on Mt. Suribachi. Rather, it is a landing craft of "average" Marines, most in their 20's, throwing themselves into the raging inferno, despite their fears and trepidations. Home must have seemed like a distant planet. We owe them everything.

Sunday reruns

Must be a full moon. Today I had some of the following exchanges with patients:


Dr. Grumpy: "I'd like to see you back in a month".

Ms. X "I'll be here. Unless, of course, the Lord comes before then. He is coming soon, you know."





Dr. Grumpy: "How's your physical therapy been going?"

Ms. Y: "I stopped going because angels have been surrounding my bed at night to heal me."





Dr. Grumpy: "How long have you been seeing Dr. Smith for your heart problem?"

Mr. Demented Psychotic: "Since he raped me in prison".

(for the record, Dr. Smith has never been in prison, nor raped anyone, that I am aware of)

More artisanal crap

Okay, my intense hatred of the overused word "artisanal" (and its derivatives) is pretty well known.

But this one is thoroughly annoying:





Let's look at this:

1. It uses the word "artisan" twice. Once to make you nauseous, and once to make you puke.

2. It's a FREAKIN' JAR OF HONEY PEOPLE! Humans can't even make it.

3. The "Artisan honey keepers" are BEES! I'm pretty sure they aren't making this claim, any more than my dog claims to be an "artisan shitpile keeper."

4. If you're going to put a "gluten free" label on honey, maybe it's time we started putting "fat free" stickers on water.

Trivia answer

Earlier this week I used the term "Hufnagel's Syndrome" in a post.

It wasn't meant to get any sort of attention, I just needed to come up with a disease name.

To my surprise, my stats have since shown a surprising number of people googling "Hufnagel's Syndrome" trying to find out what it was, then being directed back to the post. I've also received about 20 emails asking about it.

So here is the answer: There is no such disease.

The name idea is from a TV show I grew up watching, St. Elsewhere, set in a teaching hospital.

Florence Hufnagel (played by the mostly forgotten, but truly awesome, Florence Halop) was a recurring character. She was the classic patient-from-hell that we all encounter during our training (I didn't realize how accurate her portrayal was until I did my residency 10 years later). She was comically abusive and sarcastic, and made you realize how hard it could be to try and take care of someone you couldn't stand.

Her character made such an impression on a generation of TV watchers (and future doctors) that as recently as 2010 she was being cited in the news as an example.

In one of the most memorable scenes in TV history, Mrs. Hufnagel died from a bizarre combination of cardiac surgery complications and (more importantly) a malfunctioning adjustable hospital bed. It folded up into a V shape, bending her in half and suffocating her. Her death scene showed only one arm, sticking straight out the side of the folded bed.

In a bizarre postscript, it later turned out that she'd left her entire estate to one of the residents (Elliot Axelrod). When he met her lawyer it was (roughly) $50,000, but with taxes, funeral costs, and "an ongoing legal action with American Samoa" it left him with something like $18.73.

So, if you really want to think there's a disorder called "Hufnagel's Syndrome," I suppose it would be being killed by an electric adjustable bed.

Mistaken identity

While he's spending time in Juvenile Detention, I hope this kid gets some botany lessons.

Thank you, Nurse Kitty!

No kidding

This is a drug ad I saw in a journal recently:





What makes it great is the line at the bottom: