Thursday, March 15, 2012

Mrs. Bojangles

One of my elderly patients has just gone downhill recently, and for the life of me I couldn't figure out why.

So I had Mary bring her in.

I learned that for the last 12 years she based when to take her medications on when her dog asked to go out and pee, which was apparently pretty regular.

The dog died last month. So now she doesn't remember to take her pills.

I wanted to cry.

Wednesday, March 14, 2012

Mary's desk

Mary: "Dr. Grumpy's office, this is Mary."

Mrs. High-Maintenance: "Yes, I need to make a follow-up appointment with Dr. Grumpy."

Mary: "Okay, we can see you tomorrow, at 1:15 or 3:30."

Mrs. High-Maintenance: "No, that won't work. I can only do 10:30 in the morning."

Mary: "All right... What about Friday at 10:30?"

Mrs. High-Maintenance: "Oh sorry, it has to be a Thursday. I work at our downtown office near you every other week, so I guess that would mean a 10:30 only on Thursdays that fall on odd-numbered dates."

Mary: "Hang on... Well, the next time we can see you then would be, um, Thursday, April 5."

Mrs. High-Maintenance: "I need to be seen sooner than that! Can't you just re-schedule someone else?"

Mary: "No, we can't do that. It's not fair to other patients."

Mrs. High-Maintenance: "Well, you could be more flexible."

Tuesday, March 13, 2012

Today's featured item

Yes, the product you've all been waiting for: Now a starving vegan can eat her own purse, and not feel guilty about it!

(click to enlarge)





It's made from "animal-friendly faux leather" (i.e. PLASTIC).

By this standard cell phones, pens, and credit cards are now part of a well-balanced non-animal-product diet.

I should also note that anything called "Sacs of Life" brings a different kind of bag to mind.

Thank you, Kim!

Fax machine fun

Dear Dr. Talus,

I'm sorry your patient's cheapshit insurance doesn't cover podiatrists.

But that doesn't mean I'm going to start doing foot surgery.

I'm a neurologist. So please stop sending referrals like this to me.





Thank you,

Ibee Grumpy, M.D.

Monday, March 12, 2012

Love and marriage

Dr. Grumpy: "When did you call paramedics?"

Mrs. Leg: "Let's see... the numbness started around 10:20, and by 10:30 the leg was very weak. I couldn't use it to stand or walk or anything, so I asked Bill to dial 911."

Dr. Grumpy: "That's when they were notified?"

Mrs. Leg: "Well, no. He got up and brought me the phone during the next commercial break, then I called."

Sunday, March 11, 2012

Sunday rambling

I've touched on this before, but after getting dragged to "The Lorax" today (and no, I didn't like it. The 1971 book, or 1972 TV cartoon, were far better and more to-the-point) I noticed the same issue.

When I was in high school Quiet Riot released a cover version of Slade's "Cum On Feel the Noize" that was a smash hit. It also got censored (at least where written displays of its title were shown) because of the first word's spelling. So in stores you'd see the single (yes, folks, 45 rpm) with an attached piece of paper saying "Come" partially covering the name.

And today, where is this obscenely-spelled piece of music being used? In a movie trailer for "The Pirates! Band of Misfits" a children's claymation film cumming, I mean coming, out this Spring.

In another preview was the less controversial (unless you're Harold Camping), but still very 80's, REM song "It's the End of the World as We Know It (and I Feel Fine)" being used in the trailer for "Ice Age 4: Continental Drift".

So, the take home messages from the movie today are:

1. Any book that takes less than 20 minutes to read is unlikely to be made into a decent movie. They simply have to add WAY too much extraneous material. And this usually includes a few musical numbers.

2. The 80's will never die. Music, leg warmers, and all.

Random Sunday pictures

First off we have this post-holiday sale on "Christmas Deluxe Chanukah Candles."





Next we have this dumpster. I'd like to see the opposite, a company called "Inaccurate Trash Removal," that randomly hauls off your car, patio furniture, kids, etc.






Here we have a marketing survey on coffee, asking if people like it to be called "artisanal."





And (my favorite): if you can't afford the new iPad, or even a used one, there's this device. It's battery life is virtually inexhaustible, it can be carried anywhere, and is cleverly made from organic materials to help conserve metal.





To operate the gadget you'll need a special stylus...

Saturday, March 10, 2012

Weekend reruns

I'm tied up with kid stuff today, so thought I'd re-post one of my favorite historical oddities. If you enjoy this sort of trivia, please check out my collection of history posts.






In 1941-1943, the Axis U-boats dominated the Atlantic, and the Allies were looking for an answer. The airplane was an effective anti-submarine weapon, but the logistics of using planes in the Atlantic were daunting. Aircraft carriers were urgently needed in the Pacific and Mediterranean. Land based planes' range was limited, and could only cover portions of the Atlantic. So there existed a "black gap" in mid-ocean, where the U-boats could roam at will.

So the naval staff of Britain came up with a remarkable idea, which was named Project Habakkuk: to build a gigantic aircraft carrier out of ice. And, as crazy as it sounds, it may have worked.

Normal ice shatters, and melts. A British engineer, Geoffrey Pyke, developed a mixture of ice and wood pulp called Pykrete. The new material was surprisingly resistant to blunt force. As temperatures rose, the wood pulp formed a fuzzy coating over the ice, insulating it from further melting. Experiments on Pykrete were conducted in top secret, in a refrigerated meat locker beneath Smithfield meat market in London. Frozen animal carcasses were used to hide the research areas.

The size of these ships would have been remarkable. The initial design was for a floating airfield 5000 feet (1524 m) long, 2000 feet (610 m) wide, and 100 feet (30 m) high. Later designs were shortened to 2000 feet long. They would have a displacement of 1-2 million tons. By comparison, the huge aircraft carriers in use today by the U.S. Navy are just under 1100 feet long and weigh 101,000 tons.

They could handle the biggest planes of the era, and carry enough food and fuel to resupply them for months. They had externally mounted power plants capable of propelling them at 6 knots, and would act as floating airfields in the North Atlantic. They were cheaper, and could be built much faster, then a conventional carrier, and had an estimated lifespan of 6-18 months (likely longer, as it turned out).

To see if the idea would work, a 60 foot scale model was built at Patricia Lake, in Canada, over the winter of 1942-1943. To preserve secrecy, the Pykrete blocks were made at Lake Louise, and moved to Patricia for assembly. And it worked quite well. In Summer the wood pulp covered the ice and slowed the rate of melting. Auxiliary cooling equipment was developed that could be carried outside the hull.

Churchill thought quite highly of the idea. The ships would be built in Canada, and to this end the Canadians began assembling enough ice and wood pulp to begin construction.

More and more technical problems, however, came up, and by the time they were sorted out the tide had started to turn against the Axis. The Liberty ships were being built faster than U-boats could sink them. The Allies had developed small, relatively cheap, escort aircraft carriers, which were now providing air coverage to Atlantic convoys. Long range patrol bombers had improved. And so one of the most remarkable ideas in naval history was quietly shelved.

The model built at Patricia Lake took 3 years to melt, showing that Pykrete was quite durable. It was allowed to sink into the lake.

And there, at the bottom of Patricia Lake in Alberta, Canada, lie the remains of Habakkuk. The test ship's frame, with a small motor and refrigeration plant, are now visited by scuba divers. Jasper National Park receives many visitors every year, most unaware that at the bottom of a small, serene, lake is all that's left of this remarkable idea.

Friday, March 9, 2012

Home

Dr. Grumpy: "Hey Craig, how did you do in the class debate?"

Craig: "I did okay. I'm the first alternate for my class debate team. So if another kid, like Jeff, gets sick than I'll be on the team."

Dr. Grumpy: "That's great!"

Craig: "Since you're a doctor, can you write me a note to take to school tomorrow? Something that says Jeff is sick, and can't participate?"

Thursday, March 8, 2012

Nudge nudge wink wink

Dr. Grumpy: "It looks like you have carpal tunnel syndrome."

Mr. Arm: "I can believe it. I've been doing the same repetitive motion with my right hand every day for 39 years."

Wednesday, March 7, 2012

Gone with the Wind

While picking up the kids from school on this blustery day, I overheard two women having a shouted conversation in the parking lot:

Mom 1 "BOY! IT SURE IS WINDY TODAY!"

Mom 2: "WHAT?"

Mom 1: " I SAID, BOY, IT SURE IS WINDY TODAY!"

Mom 2: "I CAN'T HEAR YOU! IT'S TOO WINDY!"

Snort

The DATscan is a test used for assessing patients with unclear types of tremors. Like many other tests, there are some medications you have to stop a day or two in advance.

So the guidelines include a helpful list of all such drugs, and their time frames.





I personally like this one:




"Hey, Phil, in order to take the test, you need to stop hitting the blow for 2 days."

Tuesday, March 6, 2012

Language

While on call this past weekend I discovered this line in another neurologist's note:

"An ictal event is possible, and cannot entirely be excluded, however our data to implicate such process definitively is somewhat tenuous at this point in time."

Monday, March 5, 2012

Care

Dr. Concerned Internist: "Hello?"

Dr. Grumpy: "Hey, Susan. It's Grumpy. I need to talk to you about Mrs. Aspirin."

Dr. Concerned Internist: "What's up?"

Dr. Grumpy: "Well, you referred her to me for a TIA, so I ordered a carotid ultrasound. Her arteries look okay, but on one side she's got a small thyroid nodule, and the radiologist is worried it's malignant."

Dr. Concerned Internist: "So why are you calling me?"

Dr. Grumpy: "Well, it needs further work-up, and you're her internist."

Dr. Concerned Internist: "You ordered the test that found it, so it's your problem now."

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