Today's pop quiz

You've won $75,000 in the state lottery! To celebrate, you:

A. Go out to dinner, then pay off some bills.

B. Go on a cruise (preferably one with working toilets).

C. Buy that Prius you've had your eye on for years.

D. Buy some meth, marijuana, and bongs, then blow up your house.

3 Act Drama

Act I: Tuesday, February 5th.

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

Ms. Frantic: "I need to get in right away! The toes on my left foot are numb, and I went to ER! They told me I should see a neurologist."

Mary: "Okay... We can see you on Thursday, the 7th, or..."

Ms. Frantic: "THIS IS URGENT! I COULD BE DYING OR SOMETHING! I NEED TO GET IN TODAY!!!"

Mary: "Thursday is our next opening, I'm sorry."

Ms. Frantic: "That's crazy! I need help! I'm going to call another doctor!"

Click



Act II: Tuesday, February 12th

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

Ms. Frantic: "I called a week ago, and couldn't get in, and my left toes are still numb, and I really need to see a doctor!"

Mary: "Okay... We can see you this Friday, the 15th, or..."

Ms. Frantic: "WHY CAN'T ANYONE HELP ME? I NEED TO GET IN TODAY!!!"

Mary: "When you called last week you said you were going to find another doctor."

Ms. Frantic: "They couldn't get me in before Friday, the 15th, either, and I want to be seen today!"

Mary: "Sorry, but we can't get you in before then, either."

Ms. Frantic: "Why doesn't anyone care anymore?"

Click



Act III:  Morning, Friday, February 15th.

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

Ms. Frantic: "I changed my mind! I want that appointment you have for today!"

Mary: "I'm sorry, it's been filled. We can see you next Wednesday, the 20th."

Ms. Frantic: "How could you do this to me? You should have held that spot in case I called back! You know I need to see a doctor!"

Mary: "I thought you said you had an appointment with another neurologist for today?"

Ms. Frantic: "I do! At 2:30!"

Mary: "So why are you calling us?"

Ms. Frantic: "I didn't like the way his receptionist treated me when I called to confirm the appointment this morning."

Mary: "Okay, that's your business, but we can't see you before next Wednesday."

Long pause

Ms. Frantic: "Never mind. I think I'll just cancel the appointment. My foot got better, anyway."

Click

Sunday reruns

At the hospital last week I saw a 20-something guy for a head injury.

He had a fight with his girlfriend outside a restaurant and said he was going to teach her a lesson.

So he began repeatedly banging HIS head against the concrete sidewalk until he was covered with blood. At some point police and paramedics pulled up, and to continue proving his point, he began banging his head repeatedly on the police car's windshield until it shattered.

He then went back to smashing his head on the sidewalk, which continued until he got tasered, and then needed Valium.

The admitting diagnosis was "Self assault"

Exactly what lesson his girlfriend learned from this is unclear, but I suspect it had something to do with getting another boyfriend.

Book 'em, Danno!

Wednesday night I was doing a survey about drug reps, and one of the questions asked where I encounter them:

I must say, I LOVE the correctional facility option. In my younger days I did see patients at a prison clinic, but don't remember a drug rep ever calling there. Yesterday I asked several reps, and none of them had ever heard of it, either.

Since I'm able to fill out this survey, I have to assume they don't think I'm the one in jail. Which leaves just one option. And I'm not driving down to the hoosegow to visit a rep.*

*The odds of a rep being incarcerated depends on the pharmaceutical company they work for.

Mary's desk, Wednesday afternoon

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

Mr. Whirlaway: "Hi, does Dr. Grumpy treat seizures?"

Mary: "Yes, sir."

Mr. Whirlaway: "Does he make house calls?"

Mary: "Not routinely... What are the circumstances?"

Mr. Whirlaway: "Well, a friend told me Dr. Grumpy had helped his kid's epilepsy. I have a horse with seizures, and I don't like our current vet."

Memories...

Menopause has had a lot of names over time. One of the old ones, not used as much today, is climacteric.

When I was doing my internship, there was an eastern European guy named Pedrus in my class. Pedrus had just immigrated, but had a decent grasp of English.

Occasionally, though, he'd encounter something that he only knew in the medical-speak of his home country. When that occurred he'd grasp at the closest-sounding English phrase he knew, and use that.

One night he was on call, and I picked up his admissions the next morning. One of the patients was a lady in her 60's.

Pedrus, in his note on her past GYN history, had written "the patient began her climax at age 51, and it has since continued."

The marketing mindset

Last night I was at a market research interview, and we had this exchange. I have no idea what it means.


Suit guy: "Doctor, please look at this graph, showing speed of onset after the patient uses the drug's inhaler. What are your thoughts?"

Dr. Grumpy: "Well, it's pretty consistent, regardless of pulmonary function, but obviously the patient will have to be trained to use it properly."

Suit guy (makes notes): "And here, do you think this instruction sheet is self-explanatory?"

Dr. Grumpy: "Yes, but it would be nice to also have a demo unit in the office, to show patients how to use it."

Suit guy: (makes notes) "Who was your favorite superhero in childhood?"

Dr. Grumpy: "Doctor Fate."

Suit guy: (makes notes): "This page shows the side effect profile compared to placebo, with frequency of drug discontinuation on the left..."

AYFKM?

Dr. Grumpy: "Okay, sir, we'll check some labs, and I'll see you back after they're done... Any questions?"

Mr. Gravid: "No."

Lady Gravid: "Yeah, I have one."

Dr. Grumpy: "Go ahead."

Lady Gravid: "Do you mind if I look through your patient charts before we leave?"

Dr. Grumpy: "Uh, yeah, I do. They're medical records. I can't allow that."

Lady Gravid: "Oh, I don't need to read them, I just want to look at patient names."

Dr. Grumpy: "Okay, but I still can't allow that. Sorry."

Lady Gravid: "Please? We're trying to think of baby names, and I don't like any I've seen so far."

Random Sunday pictures

First, we have this pen. Doesn't say if it needs batteries.

Next, in the same theme, we have this picture. Taken in Philadelphia ("The City of Brotherly Love") this was found drawn on somebody's car hood following yesterday's blizzard.

For those of you who can't handle Diet Coke, tea, or coffee to perk up, you can now shower with caffeinated soap.*

*I should note that its efficacy is likely dubious. Transdermal absorption of caffeine generally requires it being held in place for several hours, and even then you'll only get a small amount.

Here's this place, which bans cardiovascular systems, or cardiologists, or something.

Sheesh. So much for coming here for Valentine's Day.

And last, I think we could all use a lesson from Bert: There are some neighborhoods that are best avoided.

"That's the last time I go pigeon watching after dark in south Sesame."

Now making house calls!

While I'm still going to be available here, those of you who are Kindle fiends can now subscribe to me on Amazon!

Yes, for only 99 cents a month (less than you'd pay for your daily Starbuck's "half double decaffeinated half-caff, with a twist of lemon" you can now have Dr. Grumpy automatically delivered to your Kindle. All the humor! All the whining! All the artisanal history lessons!

You even get a 14 day free trial!

You can sign up here.

Guest post: God and smoking

I'm tired, uninspired, and swamped today, so I'm putting up this story sent in by Brent.


Dr. Brent: "You know Mr. Nightshade, smoking isn't good for you.  It causes all kinds of health problems and it's expensive.  You really should try to stop smoking."

Mr. Nightshade: "Yeah, I know."


Next visit, a few months later.


Dr. Brent: "So Mr. Nightshade, how are you doing with smoking?"

Mr. Nightshade: "I quit."

Dr. rent: (rather shocked and dumbfounded) "Wow! That's great! What finally made you decide to stop smoking?"

Mr. Nightshade: "God told me to stop smoking."

Dr Brent: "Err, that's wonderful that you stopped smoking."


Next visit a few months later:


Dr. Brent: "So, Mr. Nightshade, how are you doing?"

Mr. Nightshade: "I'm fine, but I'm smoking again."

Dr. Brent: "Oh, why's that?"

Mr.Nightshade: "God told me to stop smoking, so I stopped smoking. But the more I thought about it, the madder I got. I like to smoke, so why should God tell me to stop smoking?  It made me really mad. I wasn't going to let God tell me what I can and can't do, so I started smoking again and I told him to be quiet."

February 7, 1910

HMS Dreadnought

On this day in history, what is possibly the greatest prank ever was pulled off. And its victim was none less than one of the world's most venerable military forces, the Royal Navy.

To set the backdrop:

In 1910 the HMS Dreadnought was the first of a whole new type of battleship. She was, at the time, the most advanced, powerful, weapon of war ever built. The 1910 equivalent of a top-secret nuclear ballistic missile submarine.

The joke started in the mind of Horace de Vere Cole, a poet and notorious prankster. An example of his humor was this: An old schoolfriend had just been elected to Parliament. While walking together through London, Cole challenged him to a foot race, then let him get ahead. Unbeknownst to the friend, Cole had slipped his gold watch into his jacket pocket, and as he chased him yelled, "Stop! Thief!" The friend was detained by police until Cole explained it was a joke. Another time he purchased theater tickets for all his bald friends- and he'd chosen their seats specifically so that their heads spelled out an obscenity when viewed from the balcony.

But I digress.

Cole recruited 5 friends from a circle of writers and artists to help him, including Virginia Stephen - who'd later become famed novelist Virginia Woolf.

On February 7, 1910, HMS Dreadnought was moored in Portland Harbor, Dorset. Cole had a forged telegram, allegedly from the UK government's foreign office, sent to her commander. It said they'd be receiving a visiting delegation of princes from Abyssinia (now Ethiopia), and to offer them all courtesies.

4 of Cole's accomplices put on heavy blackface make-up, glue-on beards, and elaborate theatrical costumes. Cole went as "Herbert Cholmondeley" of the UK's foreign office, and the 6th participant (Adrian Stephen, Virginia's brother) went as a translator.

The fake Abyssinian delegation: Virginia Woolf is on the far left, her brother Adrian in the bowler hat at center, and Horace de Vere Cole at the right.

With this group behind him, Cole marched into London's Paddington Station and, claiming to be a government officer, demanded a train be immediately prepared to take them to the Dreadnought. The impressed railway employees gave him a VIP coach with private staff.

Meanwhile, in Weymouth, frantic British officers organized an honor guard to greet the train. To their horror, nowhere in the Royal Navy's music list or flag collection was there anything for Abyssinia. So the band was given the national anthem of Zanzibar instead, and hung the Zanzibar flag, hoping the visitors wouldn't notice (they didn't).

The group was welcomed with full military honors, and inspected the anchored fleet. The highlight came when they boarded and toured the magnificent Dreadnought herself. Enemy spies had spent years trying to ascertain her technical details, and here the Royal Navy was willingly escorting a group of costumed literary goofballs on board and showing them around.

As they walked up the gangplank it started to rain, and to their horror the make-up began to run. Cole rushed the group inside before anyone noticed, explaining that royalty shouldn't get wet.

During the tour, the Abyssinian princes excitedly chattered in a nonsensical foreign tongue, which was a random, improvised, combination of Greek, Latin, and gibberish. Adrian Stephen made up questions as they went along, and "translated" them (and the answers) back and forth. The group exclaimed "Bunga! Bunga!" at things that were particularly impressive. This so struck nearby sailors that it entered British lexicon for a time, and was recently (2011) resurrected in Italy referring to the behavior of Prime Minister Silvio Berlusconi.

While on the train ride, Cole had created names for each of the 4 "princes," but forgot who was who during the tour. So their names changed from minute-to-minute. The naval officers didn't notice. At one point they were guided by an officer who was a cousin of Virginia and Adrian Stephen, and who also knew Cole personally, yet he didn't recognize them (and Adrian & Cole weren't even in costume!).

As their tour ended the members tried to bestow the "Order of Abyssinia" medal on several officers (actually a cheap trinket Cole had bought en route). The Dreadnought's cooks had prepared a special meal for them, but they declined to eat, with Cole stating that for religious reasons they were concerned the food wasn't prepared correctly (the real reason was that eating or drinking would ruin the make-up and fake beards).

The group were again saluted by the honor guards and Zanzibar national anthem as they left, boarding the train back to London.

A few days later Cole leaked the story, complete with photos, to the London newspapers. It became front page news. The Royal Navy was horrified, and the mighty Dreadnought was promptly dispatched on "machinery trials" until the mess blew over. British sailors were greeted in the streets with "Bunga! Bunga!" and Parliament tightened regulations on ceremonial visits. The navy threatened to have the perpetrators caned, but in the end no one was punished.

Several months later the real Emporer of Ethiopia, Menelik II, came to England, and the navy turned down his request to visit the fleet to avoid embarrassment (perhaps they still hadn't found a flag or national anthem).

A final note came in 1915, during World War I. The Dreadnought rammed and sank a German U-Boat, and after returning to port her captain received an anonymous telegram that simply said "Bunga! Bunga!"

WTF?

Last night a paid survey "exclusively for neurologists" showed up in my mailbox, so I clicked on it.

One of the qualifying questions was how many of each of these disorders I treat in a month:

Needless to say, I didn't qualify

Seriously, people, I'm a freakin' neurologist. How much effort did you put into this survey?

Worries

Dr. Grumpy: "Have a seat... I'm Dr. Grumpy... What can I do for you?"

Mr. Frio: Hi... You know, I got a cup of water in the lobby when I came in. I was thirsty and all."

Dr. Grumpy: "Uh, huh..."

Mr. Frio: "It was really cold. I mean, maybe too cold."

Dr. Grumpy: "I'm sorry, I..."

Mr. Frio: "I wasn't expecting warm water, don't get me wrong. But I wonder if it's safe that the water is that cold."

Dr. Grumpy: "I'm sure it's safe. Now, to get back to why you're here..."

Mr. Frio: "I like cold water as much as the next guy, but this was really cold. Colder than I think it needed to be. You should look into this. Someone could get hurt."

Dr. Grumpy: "I'll let Mary know, she's the person in charge of that."

Mr. Frio: "Thank you."