Tuesday, April 17, 2012

Annie's desk

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

Mr. Gardner: "Yeah, I saw Dr. Grumpy last week for my arm problems."

Annie: "What's up?"

Mr. Gardner: "My accountant is out of town. Does Dr. Grumpy recommend cash value or term life insurance policies?"

Monday, April 16, 2012

Patient quote of the day

"I hope you realize that your capabilities as a physician thus far appear to be entirely suboptimal."

Smooth jazz

Dr. Grumpy: "How's your jazz band doing?"

Mr. Armstrong: "So-so. Our last gig was at a dump."

Dr. Grumpy: "Sorry. One of the cheap college bars?"

Mr. Armstrong: "No, the dedication for the new city landfill."

Sunday, April 15, 2012

Weekend reruns

I had a busy day at the office, so didn't get a chance to return calls until I got home. I had to call a 20-something patient to give her (normal) MRI results. Here was the conversation:

Miss Suzy Singlefemale: "Hello?"

Dr. Grumpy: "Hi Suzy, This is Ibee Grumpy."

Miss Singlefemale: "Oh! I am SO glad you called. I've been meaning to call you back, but I've been sick for 2 days, and have been running errands, but I didn't want you to think I was blowing you off. I had the most INCREDIBLE time with you on Saturday night!"

I was speechless. Finally I said:

Dr. Grumpy: "Uh, I just called to discuss your MRI results."

LONG pause.

Miss Singlefemale: "Is this Dr. Grumpy? Oh, I thought you were someone else. How
are you this evening?"

Saturday, April 14, 2012

April 14, 1912




"There was peace and the world had an even tenor to its way. Nothing was revealed in the morning the trend of which was not known the night before. It seems to me that the disaster about to occur was the event that not only made the world rub it's eyes and awake, but woke it with a start - keeping it moving at a rapidly accelerating pace ever since, with less and less peace, satisfaction and happiness. To my mind the world of today awoke April 15th, 1912."

-Jack B. Thayer, Titanic Survivor



Today is 100 years since the Titanic struck an iceberg and sank (yes, I know the sinking was on the 15th, but I'm going to mark the 14th, since that's when the collision occurred and started the chain of events).

I've done annual posts on lesser-known aspects of the disaster, and obviously had quite a bit of time to think about what would be appropriate for today. I hope you enjoy this, as I've tried to connect it with something we still have 100 years later.


The Titanic's story has formed the basis for movies, computer games, TV shows, novelty ice cubes, and books. Even a few musicals (such as the Las Vegas Jubilee comedy-musical-topless show about the sinking), and, most bizarrely, a childrens' inflatable slide.

Lost in all of this is a tragedy in which over 1500 people died. I think any of us would be horrified to see "Holocaust- The Musical!" or "September 11 - a laugh-a-minute review!" and it always irks me that the
Titanic's needless loss of human life is often treated as on object of amusement.

Lastly, all of us with an interest in the story owe a debt to the late Walter Lord. Without his research and compelling writing it would likely have been forgotten along with many other turn-of-the-century shipping disasters.
 

And on with the post.









The Sundowner


The Sundowner (a comical name for those of us in medical profession) is a 58 foot (18m) motor yacht at the Ramsgate Maritime Museum in England. She was, coincidentally, built in 1912, the same year the Titanic sank. She's a fairly nondescript boat, and certainly nothing like the huge ocean liner. One man was to link the 2 ships, both times with remarkable heroism.





Charles Herbert Lightoller


Charles Lightoller was born in Lancashire in 1874. His mother died shortly after his birth from delivery complications, and his father (who owned a cotton mill) abandoned him and left the country a few years later. Both his siblings died in childhood.

When he was 13 Charles signed on to an at-sea apprenticeship, and between 1887 and 1899 went on journeys that led him to being shipwrecked & rescued once, fighting an at-sea fire that threatened his ship, catching malaria, prospecting for gold in the 1898 Klondike gold rush, becoming a cowboy in Alberta, riding railroads as a hobo across Canada, and working as a cattle wrangler on a livestock freighter back to England. He was 23 years old, had circled the world twice, and was penniless upon returning home.

He worked his way up to a Master's certificate, and in 1900 joined the White Star Line, gradually rising in the ranks. He married and had 5 children (2 girls and 3 boys - all served in WWII, with 2 sons killed in the fighting).

In 1912 he was named 1st officer of the brand-new Titanic, though shortly before the voyage a new chief officer was brought aboard, knocking Lightoller down a notch to 2nd officer.

He was off-duty when the ship struck the iceberg, but once alerted quickly went to work. He supervised lowering the port-side lifeboats, never trying to get in one himself. After all the boats were gone and the ship about to go under, he felt he could do no more, and dived into a wave that was breaking over the now-submerged officers' quarters.

As tons of seawater poured down the Titanic's ventilators, he was sucked under, and pinned against one's grating. If it had broken he'd have been sucked deep inside the dying ship and never found, and the suction was so powerful he couldn't break free and swim to the surface.

He'd been trapped underwater for 15-20 seconds when a boiler ruptured deep in the dying ship, sending up a blast of hot air that broke the suction and launched him to the surface.

Reaching the air he was in 28°F (-2° C) water, in which a person couldn't survive more than 15 minutes. He was near lifeboat B, which had overturned, and had about 30 men clinging to it. He swam over and crawled aboard.

Without oars they were unable to move away from the sinking ship, and may have been sucked down with her. But when the first smokestack collapsed into the water (and likely killed many beneath it) the wave pushed their overturned boat safely away.

The upside-down boat was swamped and unstable, and the men clinging to it were in danger of being thrown off in the swells. Lightoller quickly arranged them standing on its bottom in parallel lines, and ordered them to lean right or left to counteract the waves. When the Carpathia came in the morning they were the last boat to be picked up. Lightoller himself was the last survivor of the disaster to be brought aboard, and the highest-ranking officer to live.

He testified at both the British and American hearings, and many of his recommendations to prevent similar disasters from occurring were agreed to by the major maritime nations. Several of them stand to this day (lifeboat drills, enough lifeboats for all aboard, continuous radio communication by all vessels for distress signals, and ship-to-ship notification of icebergs).

He served his country in WWI, receiving decorations and commanding 2 ships. He was sunk (and rescued) again during the war, and later rammed and sank a German U-Boat.

After the war he returned to the White Star Line, but discovered that his association with Titanic had blacklisted him from advancing. He became discouraged and left the sea, taking jobs as an innkeeper and chicken farmer, and writing his autobiography.

But his heart never left the sea, and in 1929 he and his wife bought the little Sundowner and sailed her around Europe.

In 1940 came Great Britain's darkest hour.

Hitler's seemingly invincible armies were swarming across Europe, and a large portion of Britain's armies were trapped at Dunkirk by the invaders. Their options were to surrender or die fighting.

Churchill's government requisitioned every ship and boat available to evacuate them home, and at age 66 the now-retired Lightoller and his oldest son volunteered to take the little Sundowner across the English Channel to help.

Without any armament they set out, dodging strafing Luftwaffe planes. Halfway across they came across another boat that had broken down and caught fire, and rescued her crew. Then Lightoller sailed on. Upon arriving at Dunkirk he took the Sundowner alongside another ship, which quickly off-loaded soldiers to his, then went back for more. He headed back to England with 130 men crammed in his vessel (built to carry perhaps 20 at most). Badly overloaded, the Sundowner was barely maneuverable, but with his experienced hand on the wheel she avoided further airplane machine guns and the wakes of larger ships that threatened to overturn his.

He unloaded the soldiers and was ready to return for more, but with the worsening conditions only faster ships were being sent. The little Sundowner spent the rest of the war doing coastal patrol, and in 1945 she returned to being a pleasure boat. Lightoller and his wife spent the rest of their years sailing her.

Lightoller died in December 1952, a victim of another man-made disaster, the Great London Smog.

His wife continued sailing Sundowner, leading a repeat procession of boats back to Dunkirk in 1965 for the 25th anniversary of the evacuation. After her death the boat had several owners before being purchased by the Ramsgate Maritime museum, and has since led the memorial procession back to Dunkirk twice more (1990 and 2000).

Today this connection to the past is still with us. While the wreckage of the once magnificent Titanic reminds us of her 1500 dead and the lessons taught by the tragedy, the little Sundowner reminds us of courage in the face of adversity- perhaps our most noble capacity.

Friday, April 13, 2012

How to rob a bank

Lesson 1: Be intimidating.

Do they pay you by the word?

Last night I was looking through a hospital chart, and discovered this in another neurologist's note.

"The patient has had an electrical dysfunction of the cortex, resulting in abnormal neuronal discharges. The resultant signal propagation caused generalized tonic-clonic muscular activity."


Dr. Grumpy's translation: "He had a seizure."

Thursday, April 12, 2012

Medical humor

Knock knock
Who's there?
HIPAA
HIPAA who?
I can't tell you that.

Thank you, Webhill!

The country club life

Dr. Grumpy: "When did the symptoms start?"

Mrs. Howell: "We were at a party, on our friend's yacht. It's a big yacht, not like the little ones poor people have, and I went to lay down, when..."

Wednesday, April 11, 2012

Great Moments in Crime

"Gee, how did you guys catch me so fast?"

Thank you, Ed!

Reasons I'm going to hell

Before leaving last night I looked at today's schedule. One of the new patient's listed was familiar, and I searched my charts. It was a lady I'd fired 7 years ago for various reasons. She'd been referred back to me by her new internist, Dr. McCheese, who likely hadn't been told of my history with her. Mary had missed the problem.

So I talked to Mary. She'd forgotten I'd fired the lady, and said she hadn't spoken to the patient. Dr. McCheese's office had scheduled the appointment.

Dr. McCheese doesn't normally refer to me, so I really didn't care about making him angry. I called his office and reached the lady who'd made the referral.

Dr. Grumpy: "I'm not going to accept this case. She can't come back here."

Office Lady: "Well that's just freakin' GREAT! I mean, we don't refer to you anyway, and you were our last hope. We already tried all 5 good neurologists in town, but none of them wanted to touch her either. So we thought we'd send her to you."

You have no idea how special I felt. There are about 80 neurologists in my town, not including the one who died on Monday, and I didn't know that only 5 of them were competent.

Dr. Grumpy: "Sorry. I'm not taking her."

Office Lady: "So now what am I supposed to do?"

I thought about telling her to go stuff herself, but an even better idea came to mind.

Dr. Grumpy: "Why don't you refer her to Dr. Justdiedmonday?"

Office Lady: "I hadn't thought of that. He isn't on our list either. Do you think he'd see her?"

Dr. Grumpy. "It can't hurt to ask. I heard he has some schedule openings this week."

Office Lady: "Thank you! I appreciate your help. I'll call his office right now."

Dr. Grumpy: "Have a good night."

Tuesday, April 10, 2012

Mary, bring me a gavel

Dr. Grumpy: "So when did this start?"

Mrs. Tia: "Well, we were at dinner, and I'd just started some chocolate pudding, when suddenly I had trouble talking and..."

Ms. Daughter: "Mom, you were having tapioca pudding."

Mrs. Tia: "No, it was chocolate. I hate tapioca pudding."

Ms. Daughter: "No, I'm the one who hates tapioca. It makes me sick that you order it."

Mrs. Tia: "I wouldn't have ordered it because I can't stand it. That's why I got chocolate."

Ms. Daughter: "Maybe you should consider a restaurant with better desserts."

Mrs. Tia: "Maybe you should think about why Robert left you."

Ms. Daughter: "I didn't bring you here to fight with you."

Mrs. Tia: "Could have fooled me."

Ms. Daughter: "I hate all kinds of pudding, anyway."

Monday, April 9, 2012

Priorities

Dr. Grumpy: "How did this start?"

Mr. Walton: "We were in line at Walmart, returning a toaster. It was a real POS, know what I mean, Doc? It burned everything. Anyway, Ma began telling me that her left arm and leg were weak, and so I helped hold her up. After we returned the toaster I carried her out to the truck, and drove her to the hospital."

Dr. Grumpy: "Okay, what time would you say this all started?"

Mr. Walton: "We were in line about another 20 minutes after she first said something."

Dr. Grumpy: "Why didn't you bring her in or call 911 right away?"

Mr. Walton: "We'd already been waiting for 20 minutes and I didn't want to go back."

Sunday, April 8, 2012

Weekend reruns

From December, 2008:


Okay, so at this time of year we get tons of cookies, candies, fattening stuff in general, dumped at the office.

A few weeks ago a local physical therapy place that specializes in hands dropped off a bunch of hand-shaped frosted sugar cookies.

Our staff was pigging out. I kept asking them to set one aside for me and put it next to my coffee in the break room, but they ignored me, as the cookies gradually decreased in number.

Finally I said "Somebody put a cookie near my coffee, or I'll have you all shot!" Then I went in to see my next patient.

When I wandered back to the break room 20 minutes later, they had saved me this cookie.


 
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