Thursday afternoon

Mrs. Patient: "I think my mother, Lucy, saw you several years ago."

Dr. Grumpy: "She may have. What's her last name?"

Mrs. Patient: "I don't know anymore. She changes it all the damn time."

Found in a hospital chart

I don't know what it is. But it sure sounds bad.

For non-medical readers: The real phrase is "subarachnoid hemorrhage," which is a bleed in the spaces around the brain.

History in 1:37

All shook up

My cell phone rings while I'm with a patient. It's one of my call partners office.


Dr. Grumpy: "Hello? This is Dr. Grumpy."

Voice: "Please hold for Dr. Nerve." (This drives me nuts. WTF can't other doctors dial a damn phone?)

Dr. Nerve: "Hello? Ibee?"

Dr. Grumpy: "Hi. What's up?"

Dr. Nerve: "Can you trade call with me for this weekend? I just found out that my (soft voice) mumble whisper gargle is in town."

Dr. Grumpy: "That should be okay. What did you say was happening?"

Dr. Nerve: "My (whispers) mmph chz fumph is in town."

Dr. Grumpy: "I still can't hear you."

Dr. Nerve: "Hang on, let me close my office door so my staff can't hear me... I said my favorite Elvis impersonator is in town."

Probably bothers bystanders, too

Dr. Grumpy: "How are you doing with the new medication?"

Mr. Firearm: "Fine. The tremor is much better. Now it only bothers me when I'm shooting a handgun."

Veteran's Day

Veteran's day is to thank those who have served the militaries of our respective countries. We throw parades, hold services, and honor our warriors in many ways. But it should never be forgotten that not all veterans walk upright.

Sergeant Stubby, United States Army

No one knew when or where he was born. In common terms he was just a stray dog.

It was an early morning in 1917 at Yale Field in Connecticut. The area had been taken over by the U.S. Army for training, and a group of young soldiers was there, preparing for World War I across the Atlantic.

At some point a medium-sized dog wandered onto the field, and took an interest in the young men. They befriended each other, and Private J. Robert Conroy liked him enough to take back to their base that night.

The dog, though officially not supposed to be there, quickly became a part of the camp. He got used to the daily routine of orders and bugle calls. He even learned to salute: when he saw humans all doing it around him, he'd put his right paw on his eyebrow.

Eventually Conroy and his division were ready to ship out for the war in Europe. Rather than abandon the dog (now named Stubby) they smuggled him (under coats) aboard the troopship S.S. Minnesota for the journey across the sea.

Stubby turned out to be far more of a dog than his finders ever expected. Staying with his owners, he served in combat in France. He lived in the frontline trenches with the 26th Infantry (102nd division), for over 18 months. His first battle was in February, 1918, and overall he fought in 4 major offenses and 18 ground battles.

Frontline trench warfare is a nightmare, but Stubby, like his fellow soldiers, learned to live with it. At one point his position was under 24-hour continuous enemy gunfire and shelling for over a month. He never deserted his company or position.

In April, 1918, he was wounded by an enemy hand grenade, and sent to Red Cross facilities. While recovering he improved morale there by routinely visiting other wounded soldiers. After healing he went back to his company in the front.

Later that year he miraculously survived a gas attack in the new era of chemical warfare (though was extremely ill for several days afterward). He quickly learned to recognize the smell long before his primate colleagues could. Later, when the Germans launched another surprise gas attack in the early morning, Stubby noticed it first. He ran through the trenches, barking and even biting his comrades to waken them so they could put on their masks. Since there were no gas mask to fit him, after spreading the alert he'd run out of range behind the trench and wait there until the all-clear was sounded.

His keen ears could hear the high-pitched whine of incoming shells before humans could, and his warning barks gave his friends an extra few precious seconds to take cover.

Stubby - of his own accord - undertook some of the most dangerous missions of the war, searching no-mans-land between trenches for wounded soldiers. He could differentiate between English and German speech, and successfully led medical teams to the injured. He also was able to lead dazed, but walking, soldiers back to safety. How many lives he saved is unknown.

Later, Stubby and his men were deployed to the battle of Argonne Forest. There, while walking around on his own, he single-handedly caught a German spy that had slipped behind allied lines to map their formations. Stubby detected him behind a bush, raised the alarm, and then detained him (by holding onto the back of his pants) until 2-legged soldiers could arrive.

For his remarkable heroism and skills, the commanding officer of the 102nd division recommended him for promotion, and Stubby became Sergeant Stubby - now outranking his owner, Corporal Conroy.

Stubby's remarkable skills extended beyond the battlefield. During a visit to Paris with Corporal Conroy, Stubby suddenly dashed out into traffic and saved a young girl who was about to be struck by a car.

After allied forces liberated the town of Château-Thierry, the local women made him a chamois coat. It kept him warm and was also used for his growing collection of medals, including the Purple Heart.

After the armistice, Corporal Conroy returned home with his friend. Stubby was now a celebrity, routinely leading parades. He met 3 Presidents and was made a life member of the American Foreign Legion and Red Cross. In one instance he received a distinguished service award, presented by no less than the fabled American General, John "Blackjack" Pershing.

Sergeant Stubby leading a victory parade. His heart was bigger than his body!

As the cheers faded the pair transitioned back to civilian life. Conroy enrolled in Georgetown law school, and Stubby found employment as the team's mascot. He often performed a football halftime show, pushing a ball around the field.

He died on March 16, 1926, with Conroy holding him. He is remembered by a brick at the World War I memorial and at the Smithsonian. The latter has his remains on display.

 

 

Thank you, veterans!

With my most sincere apologies to Gilbert & Sullivan

I am the very model of a modern Major-General.
I've information vegetable, animal, and extramarital
I know the men of power, and I quote affairs historical
From Clinton through to Spitzer, in order categorical
I'm very well acquainted, too, with matters infidelical
I understand positions, both the simple and quadratical.
About the bedroom theorem I'm teeming with a lot o' news,
With many cheerful facts about the secrets of my private muse.

I'm very good at integral and differential calculus;
I know the iPhone numbers of ladies infinitacus
In short, in matters vegetable, animal, and Sildenafil,
I am the very model of a modern Major-General.

I know our mythic history, Fatal Attraction and The Graduate;
I answer ads on Craigslist, I've a pretty taste to fornicate
I quote in hidden diaries my flings in far Arabious
When up-close I can tell peculiarities paralabious;
I can bounce undoubted playmates whilst on a waterbed afloat
I know the moaning chorus from my 8-track of ye olde Deep Throat
Then I can hum a fugue of which I've heard the panting din afore,
And secretly record them all with CIA gadgets galore.

Then I can put a lingerie bill on my private credit card
And teach you ev'ry detail of what it takes to get me hard
In short, in matters vegetable, animal, and genital,
I am the very model of a modern Major-General.

In fact, when I know the secrets of a Langley Hilton one-night-stand
When I can tell at sight a Trojan from a Durex lamb,
When at affairs as sorties and surprises is so fun to be,
And when I know precisely what is meant by "promiscuity"
When I have learnt what progress has been made in male gunnery,
When I know more of tactics than Hugh Hefner in a bunnery
In short, when I've a smattering of elemental adultery
You'll say a hotter Major-General has never before slept with thee.

For my orolingual knowledge, though I'm plucky and adventury,
For I have only been going down since the beginning of this century;
But still, in matters vegetable, animal, and extramarital,
I am the very model of a modern Major-General.


The above is only vaguely based on the recent events concerning General David Petraeus. It is not meant to be taken as anything other than silly satire, and a pathetic attempt to procrastinate on reading a pile of EEG's until tomorrow.

Thank you, S.M.O.D., for the original idea.

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."