Rimshot

Dr. Grumpy: "So you've had speech therapy since the stroke. How did that go?"

Mrs. Kramden: "I think I'm doing better."

Mr. Kramden: "Oh yeah. Doc, I can definitely vouch for my wife being able to talk."

Mary's desk

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

Mr. Newpatient: "Yeah, my hand surgeon wants me to schedule an EMG with Dr. Grumpy."

Mary: "I can help you with that. Are you on any blood thinners?"

Mr. Newpatient: "I don't know. Am I?"

Mary: "Sir, you've never been here, so we have no information about you."

Mr. Newpatient: "Well, can you guys look at my medicines and tell me if any are blood thinners?"

Mary: "Sure, I can have the doctor review them... What are you taking?"

Mr. Newpatient: "I have no idea. Can you call my pharmacy for the list?"

Mary: "Um... What pharmacy do you go to?"

Mr. Newpatient: "I don't know. My wife always deals with that stuff."

Mary: "Is she there?"

Mr. Newpatient: "No. Can you call back later?"

Thank you for sharing

Dr. Grumpy: "I'll have Annie set up an MRI for you, and in the meantime..."

Ms. Rope: "Hey, do they have to tie me down to do the MRI?"

Dr. Grumpy: "No, not at all."

Ms. Rope: "That's too bad. I'm into that sort of thing."

Reflections

This post isn't funny. But I mean every word.

November 6 is always a day of special meaning to me. My first secretary (Kate) called it Independence Day.

It's the anniversary of my going into solo practice. Which, after many years, is still one of the best decisions of my life.

As most of you know, I started out with Humungous Neurology, but after a few years I got sick of endless partner meetings (AKA sociopath's roundtable), bizarre fluctuations in my allegedly fixed salary that no one could explain, office politics, and the utter bullshit that seems to come with a large medical practice. Accountants showing me charts of dollars earned vs. square footage of office space used per patient drove me nuts.

Most of the other docs at Humungous Neurology, Inc., told me I wouldn't make it on my own. That I'd be back soon. That there was no place in modern medicine for a solo doc.

But I left anyway. It was a gutsy move. I had a 1 year old. Mrs. Grumpy was pregnant with twins, and couldn't work. I hadn't run a business since age 12, when I sold used golf balls (I fished them out of a lake on a nearby course, and sold them from a card table to passing golfers). My dad helped me form a corporation, and connected me with a friendly accountant he knew.

Kate (who was here before Mary) and Annie came with me from Humungous Neurology, Inc. But my first receptionist was - my mom.

To add another item to the list of terrific things Mom has done, she became my first receptionist when Kate had to go out of town that first week. She patiently answered the phones and made notes in a scheduling book, while I frantically tried to get the phones and computers to work properly. I didn't see a single office patient that week due to a phone system meltdown (it traumatized me so much that I've never changed it since).

Kate left me after 4 years to take a job closer to her home. I was afraid I'd never replace her. I spent a sleepless night at home, and the next morning she introduced me to Mary, who she'd met working for another doctor in the building. She'd found her own awesome replacement in only one day. And Mary is still here, and still totally awesome.

Annie and I have now been together for a total of 14 years, and I can't imagine doing this without her.

I have no regrets about solo practice. It was a self-taught crash course in business: insurance, payroll, withholding taxes, purchasing supplies, etc. It certainly isn't for everyone. But when it's all said and done, I prefer this more than any group. Nobody argues with me about my choice of computers, or EMG machine, or ISP, or whatever. Nobody makes me look at Powerpoint presentations on lobby decor. And nobody shows me charts of dollars earned per square foot per patient.

I'm writing this to say "thank you" to those who have made it possible for me to be here: Annie, Kate, Mary, my parents, and (of course) Mrs. Grumpy. It takes a hell of a lot of patience (and too many other qualities to list) to put up with me.

And, of course, the patients. Without whom I'd have no practice or blog.

Thank you all so very much.

IG

Working on commission

Commission Guy: "Can I help you, sir?"

Dr. Grumpy: "I need a new iPhone case, one with a belt clip. Mine wore out and broke."

Commission Guy: "I can help you with that. You want one that lights up when you're talking?"

Dr. Grumpy: "No. Don't get me started on that."

Commission Guy: "All right, how about this one. It's on sale!"

Dr. Grumpy: "It's kind of thick... Not sure I need that."

Commission Guy: "It's a great deal, though! Normally $289, this week only $199!"

Dr. Grumpy: "ONLY $199? Uh, no, I just need something to protect it from scratches and stuff, like this $15 one here. Hey, do you have this kind in black? And with a belt clip?"

Commission Guy: "Yeah, but that won't protect your iPhone. You just said your last case broke. You need something sturdier."

Dr. Grumpy: "Maybe, but I'm not paying $199 for an iPhone case."

Commission Guy: "Your phone could get wet or dropped or something. Look at this case as an investment."

Dr. Grumpy: "Okay, I'm taking this one for $15 and going to check out. Thank you."

Commission Guy: "Wait! This $199 case is a great deal! It's bullet proof!"

Dr. Grumpy: "BULLET PROOF?"

Commission Guy: "Well, against a small caliber handgun, I mean. Couldn't you use that in an iPhone case?"

Dr. Grumpy: "I wear my phone on the right side of my belt. So, yes, if I'm worried about someone sneaking up and shooting me in the right hip I suppose it's useful. But I think I'll take my chances with the $15 case."

Commission Guy: "But..."

Dr. Grumpy: "Besides, if someone is shooting at me, the safety of my iPhone is the least of my worries."

I left and went to another store, where I got a cheap case. Upon getting home my curiosity got the best of me, and I looked online. The only bullet proof iPhone case I found was $650, and didn't look anything like what he was trying to sell me.

And then I had these visions of Linda Carter, in a 1977 Wonder Woman outfit, using an iPhone instead of her magic bracelets to deflect bullets while fighting bad guys.

Fun with online medical surveys

What happens to the documents if I take the survey in French?

Claustrophobia

"Doc, I was a Navy Seal. We trained in all kinds of stuff. I got crammed into the torpedo tubes of a submarine to land on enemy islands. I sat balled up in a fetal position for hours in the dark cargo hold of a bomber to parachute out. I fought in combat in 2 wars. But holy shit, I couldn't handle that MRI to save my life."

Dear Patient,

I know you did it. Why, I don't have a clue.

A blue sponge that I use once a week for cleaning Ed's bowl has been sitting on the edge of that sink for 12 years. The sponge changes every few years, usually when it starts falling apart. It's not used for anything else.

I'd noted it there when I took you in. Mary pulled me out for 5 minutes to take an ER call, and when I went back in it was gone. You were standing in the center of the room, zipping your purse closed. And the sponge had vanished.

I gave you the benefit of the doubt, but a search of the room didn't turn it up. So I took emergency measures, and brought a new one from home the next day.

I have no idea why anyone would want to steal a used sponge, especially from a doctor's office. I mean, it's nowhere near the kitchen, and since its sitting next to a fish net and bottle of Betta water prep I figure it's pretty obvious what it's for (sorry if I came back you before you could grab the net, too).

The sponge has been used to scrub off countless fish turds, the fuzzy goop that grows on the glass balls at the bottom during the summer months, and whatever other disgusting things are in Ed's water. I hope you aren't using it in your kitchen, or for personal hygiene.

I don't think you're so destitute as to be unable to afford one (they cost 25¢, FFS). I also hope you didn't mistake it for some kind of snack, and are now lying in ICU dying of some horrible fish shit poisoning.

Perhaps you're secretly planning on taking it to the state board of health, to see what they can culture out of it. If the plan is to get me in trouble with them, I doubt they'll care. I'm not preparing food or medicine in that sink, or washing anything. It's used solely for changing a fish once a week.

However, we know who you are. If you read this, and are currently overwrought with guilt from your life of crime, please confess at your next appointment. In exchange I will not press charges, but will gladly give you an unopened, clean, kitchen sponge, as I feel sorry that you must resort to such lawlessness.

Yours truly,

Ibee Grumpy, M.D.

p.s. I also have an extra fish net if you need one.

Communication

Dr. Pissy still uses paper charts, and has a room near my office where he stores inactive ones.

1-2 times a year his secretary makes a list of patients who have died, and moves their charts from the front shelves to a box in the storage room.

Yesterday I was talking to Mr. Patient in my office, when Pissy's secretary wandered past my door behind him. She was struggling with a pile of charts, and looked like she might drop one at any minute.

Being a gentleman (or at least trying) I stopped talking to Mr. Patient and called out, "Hey, do you need a hand with those?"

Pissy's secretary said "No, I'm okay. I'm just putting a bunch of dead people in a box."

Mr. Patient looked startled, to say the least.

I just had to do it

I was on call this weekend, and overheard...


Unit clerk (flipping through a Rolodex) "Hey, does anyone know Jenny's number?"

Dr. Grumpy: "867-5309."

Hurricane news

As the warnings for Hurricane Sandy continue to come in ("Please remain calm, we could all be killed"), my reader Tanya noticed this incredible combination of weather alerts and an advertisement on her TV:

Thank you, Tanya!

p.s. I apologize in advance if I'm unable to post for the next few days due to power outages.

The Marines: Looking for a few good men

Tomorrow, in Washington, D.C., is the Marine Corps Marathon.

My reader Amy, while trying to figure out traffic routes, discovered this, uh, interesting map of the marathon's course:

I AM NOT MAKING THIS UP! The complete map, including the above, um, segment, can be seen here.

Thank you, Amy!

Thanks, Siri

I've gotten into the habit of having Siri do minor stuff for me. Sometimes she works fine, other times... not so much.

Last night I had a marketing interview, which finished ahead of schedule. So as I got in my car I picked up the phone and said "Siri, send a text to Mrs. Grumpy: I'm done, the interview went fast."

Upon getting home I found out she received "I'm done. The interviewer and I went to France."

October 25, 1962

The North American black bear (ursus americanus) is the smallest of the continent's 3 bear species, and (comparatively) the most docile. It generally prefers to avoid humans and be left alone.


It was the Cuban missile crisis. The 2 superpowers were locked in a potentially lethal stare-down that affected lives across the globe. Both were on a hair trigger, watching for the other to make the first move.

Volk Field, in Wisconsin, wasn't one of America's larger bases. It was primarily used for pilot training and didn't even have a control tower. Planes were directed from a command center at Duluth.

In the current state of readiness, though, the Air Force had dispersed American warplanes to many such small bases across the north. Tensions were high. There was fear that Soviet agents would try to destroy the planes or runways prior to a first strike. Extra alarms had been hurriedly rigged up everywhere, alongside the dreaded klaxon that meant "launch nuclear bombers." Armed sentries patrolled constantly.

There were no drills. The pilots and planes were ready. The men had been told that, given the world situation, if the alarm sounded it was the real thing.

It was around midnight when a sentry patrolling the Duluth command center noticed a figure just outside the security fence. As he approached, it suddenly began climbing the fence, trying to get into the restricted area. This might be it. A Russian spy, trying to sabotage the bases to let the Soviets get in a first nuclear strike.

The guard fired his gun at the figure and hit the alarm button that warned of a ground intruder. The trespasser jumped off the fence and ran back into the forest on all fours- a large black bear. But the sabotage alarm had now been activated at all the bases under Duluth's command, sending armed guards racing to protect the planes.

Except at Volk Field.

Due to an undetected wiring error when the base was hurriedly readied for bombers, the nuclear war klaxon sounded there.

Fighter crews scrambled to planes. Their mission (likely one-way) was to intercept long-range Soviet bombers coming over the North Pole. Aside from other weapons, each American plane carried a single AIR-2 "Genie" rocket with a 1.5 kiloton nuclear warhead to be used against enemy formations. The Russians, once they detected American planes heading for them, would certainly retaliate in kind.

They taxied down the runway to Armageddon. Once airborne they couldn't be recalled- they were under orders to assume any ground communication telling them to come back was from the enemy. There was no control tower to correct the error before they took off.

A quick-thinking officer in the base's command center called Duluth, and learned of the mistake. There was no war, only an errant bear. He hurriedly jumped into a truck, turned on the flashing lights, and drove onto the runway, blocking the fighters from taking off and alerting them to the mistake. He was able to stop them just in time.

It was another close call.

Those involved didn't even know what had happened for another 25 years, when the incident was officially declassified.

Life on the edge is scary.