Pulp

Miss Print: "Hello, Throwaway Rags, can I help you?"

Dr. Grumpy: "This is Dr. Ibee Grumpy. You guys shipped me a huge box of magazines for my lobby."

Miss Print: "Let me see. Yes, you're on our list to receive 50 copies a month."

Dr. Grumpy: "I didn't order them, and I don't want them. Please take me off the list."

Miss Print: "Have you looked through our magazine?"

Dr. Grumpy: "Yes. It's 90% paid advertising, extolling the virtues of Wirth-Liss Pharmaceuticals overpriced medications."

Miss Print: "Well, Wirth-Liss Pharmaceuticals is paying for every neurologist to receive 50 free copies to share with your patients. Education is important. You can place them in your lobby."

Dr. Grumpy: "I don't want them in my lobby. I put them in the recycling. And I don't want to get anymore."

Miss Print: "You're depriving your patients of an opportunity to learn about their treatment options."

Dr. Grumpy: "I'm not going to argue with you. Either cancel my subscription, or let me talk to your supervisor."

Miss Print: "I'll cancel it. But you're really doing a disservice to your patients. They deserve better."

Phonetics

In the mid-2000's there were several government hearings concerning the safety of the COX-2 family of drugs (Vioxx, Bextra, and Celebrex).

A colleague of mine was working for the FDA at the time, and had to sit through hours of testimony on them. He sent me this remarkable e-mail after one:

"Today we had a military doc testify. He told us that the drugs are important in military use, because they can get injured soldiers back into battle sooner.

"He finished his speech by declaring 'Soldiers need COX-2!'

"And that just doesn't sound good when spoken."

Great copywriting moments

"Maybe an orthopedist would be better?"

Source: Here.


Thank you, M!

Footprint?

I'm not sure what to make of this.

This fan-shaped area of flattened grass wasn't there when we left yesterday morning, but it was definitely there when we got home late afternoon. It looks like a giant footprint:

Mello investigates

Anyway, if your pet therapod has escaped somewhere in Grumpyville, I think it was in my backyard today. Hope that helps.

Thank you for sharing

Mary: "Okay, I'll let Dr. Grumpy know you're here, and he'll take you back in just a minute."

Mrs. Knickers: "Do you have a bathroom I can use first?"

Mary: "Sure, it's that door to your left."

Mrs. Knickers: "I need to change my underwear. You wouldn't believe the drive I had here."

Fiat lux

Dr. Grumpy: "Let's go to my exam room..." (walks into exam room, flips on lights)

Mrs. Photic: "OH MY GOD! DID THE LIGHTS JUST FLICKER?!!!"

Dr. Grumpy: "Uh, I think so, when I turned them on. They're fluorescent."

Mrs. Photic: "THIS MEANS SOMETHING!"

Dr. Grumpy: "Everything is fine, ma'am. It only means they're on. Have a seat over there, and let me take your blood pressure.."

Mrs. Photic: "They're not going to flicker again, are they?"

Dr. Grumpy: "I don't think so, but they're old fixtures."

Mrs. Photic: "If they do, I'm leaving. For all I know you're one of them."

Um, okay, you can call it that

Frank & Craig were at sailing camp on Lake Grumpy yesterday.

This picture was in the "Sailing Instructions" pamphlet they were given.

Immature? Why yes, I am!

History reruns

June 30, 1908.

One of the most remarkable events in history happened on this date. And it's mostly forgotten.

At 7:14 a.m. a MASSIVE explosion occurred near the Tunguska river in Russia. I'm not exaggerating. The force was somewhere between 5-30 megatons. Think about that: an explosion between 150 to 1000 TIMES the power of the Hiroshima nuclear bomb. And it happened 37 years before the nuclear age began.

And, purely by chance, it happened in a fairly uninhabited part of the Earth.

To this day its exact cause is unknown, and it's simply called "The Tunguska Event." It's generally believed to have been a meteorite or comet that exploded before hitting the ground.

The shock wave it sent through the ground was a 5.0 on the Richter scale. Every tree in an 8 km (5 mile) radius from the center was killed, and the force of the explosion covered a total of 830 square miles (2,130 square km). An estimated 80 million trees were knocked over by the force- all of them pointing away from the center. A few were left standing, scorched black, with all their branches stripped off. People were knocked off their feet, and windows shattered, hundreds of miles away. The pressure wave was measured as far away as England. For the next several months there was a change in the density of the planet's upper atmosphere.

An eyewitness 40 miles south of the explosion, reported that "At breakfast time I was sitting by the house at Vanavara Trading Post, facing north. I suddenly saw that directly to the north, over Onkoul's Tunguska Road, the sky split in two and fire appeared high and wide over the forest. The split in the sky grew larger, and the entire northern side was covered with fire. At that moment I became so hot that I couldn't bear it, as if my shirt was on fire; from the northern side, where the fire was, came strong heat. I wanted to tear off my shirt and throw it down, but then the sky shut closed, and a strong thump sounded, and I was thrown a few yards. I lost my senses for a moment, but then my wife ran out and led me to the house. After that such noise came, as if rocks were falling or cannons were firing, the earth shook, and when I was on the ground, I pressed my head down, fearing rocks would smash it. When the sky opened up, hot wind raced between the houses, like from cannons, which left traces in the ground like pathways, and it damaged crops. Later we saw that many windows were shattered, and in the barn the iron lock had snapped."

There have been other impacts in recorded history, but none this powerful. And, over 100 years later, the scars are still there.



1921: 13 years after the event.







2008: 100 years after the event.


And, just remember: we live in a solar system full of flying objects.

Dear Mrs. Soda,

Please do not leave a message that you changed your mind and want to take a medication.

And, when we call you back 20 minutes later, say that you changed your mind again and now you don't want anything.

Then call just after closing to say you've changed your mind again, and would like me to call something in.

And not have a pharmacy number, or even know what pharmacy you want it called too, when I dial you back.

Then yell at me for not knowing which pharmacy accepts your insurance.

The guilt is strong with this one

It's 4:00. A guy comes in, stands at the counter.

Mary: "Can I help you?"

Guy: "Um... Yeah, I had an appointment today at 1:00, and I got called into work, and called you at around 9:00 to cancel it."

Mary: "Yes... I see that on the schedule. Did you need to reschedule?"

Guy: "I'm not sure... I mean, you're not angry at me, are you?"

Mary: "Uh, no, these things happen."

Guy: "Okay, I've been really worried about that. Thanks!"

(leaves)

Lalataw

I saw this in a hospital chart note this morning:

No, I have no idea what it means.

I've never heard of Lalataw. And I don't know why someone would, or wouldn't, want to be active in it.

Or what it has to to do with a stable guy admitted for a headache, anyway.

No fireworks

Sorry, people.

For all those writing in wanting to know what happened with Mrs 9:30, the answer is... nothing.

After getting off the phone with Mary that afternoon she looked at my office website, and realized just who the male receptionist was.

She called back and cancelled the appointment, then went to a doctor-rating site and wrote a scathing review of me and the appointment that never happened. I suspect she broke her caps-lock key in the process.

Don't ask

Dr. Grumpy: "What was your last hemoglobin A1c?"

Mr. Insulin: "7.1."

Lady Insulin: "Was it? I thought it was 8.2?"

Mr. Insulin: "No, Dr. Endocrine said it was 7.1 at my appointment last week."

Lady Insulin: "That was my appointment. Yours was in March."

Mr. Insulin: "I thought your A1c was 7.9 in March?"

Lady Insulin: "No, that was your appointment."

Mr. Insulin: "Mine was 7.1. You put it in your phone."

Lady Insulin: "I thought you put it in your phone?"

Mr. Insulin: "Why would I put yours in my phone?"

Lady Insulin: (takes out a phone) "Whose phone is this, anyway?"

Mr. Insulin: "I think the 8.2 was Sylvia's. She mentioned it at dinner last night."

Lady Insulin: "Dr. Grumpy, can you call Dr. Endocrine for us?"

We're gonna turn it on. We're gonna bring you the power.

Holy crap! Is that Morgan Freeman?

For those of you who absolutely can't bear to lose at videogames, you now have a new way to win.

For only $249 the company FOC.US is selling a headset that will run an electric current through your brain (specifically, the prefrontal cortex). Their website says it will "increase the plasticity of your brain. Make your synapses fire faster." They're marketing it as a way to improve your videogame skills for the "ultimate gaming experience."

Really.

It also comes with an iPhone app to control your jolts. And it's in your choice of red or black.

"Now I can kick my boyfriend's ass at Call of Duty."

Now, I'm not going to knock the uses of electrical brain stimulation. This is an area that's currently undergoing a lot of research as a way to treat disease and help people recover from strokes and other causes of brain damage.

But, on the other hand, let's keep a few things in mind:

1. This is electricity, for fuck's sake. It's dangerous.

2. We used to execute people with this.

3. If winning at Halo is that important, you need to get out more.

I'm sure people from FOC.US will point out that their gadget uses a low level of juice, which isn't going to hurt you (on the other hand, I have no idea if it will help. The last video game I mastered was Atari Adventure).

I have to be a bit skeptical about its benefits. I mean, the internet is full of people selling herbs, magnets, and who knows what else as ways to improve your performance at work, the gym, and in bed. Most have nothing more behind them than some half-assed data and anecdotal claims. While I think the jury is still out on cortical electricity, that doesn't make their claims true.

Another issue is that for many people, after you've plunked down a boatload of money for a game system, they don't have $249 to blow on this gadget. So what do they do?

Well, according to a recent editorial in Nature there's concern that people will start doing this as a do-it-yourself project. You could wire up with some batteries at home, or whatever you can find in the garage. There are even companies selling DIY kits for it online. This is where I think the editorial has its best line:

"That’s ‘could’ as in ‘you might be able to’, by the way; not ‘could’ as in ‘it’s a good idea’."

Granted, that's never stopped anyone from doing stupid stuff. Bigger, in the general perception, must be better. If a little battery can improve your score, then shouldn't plugging into your home's AC current be great? By the time you're playing an X-Box hopefully your parents have pulled those plastic things from the outlets that kept you from sticking a fork in them. The target audience here isn't known for being averse to risk.

What could possibly go wrong?

"Mario and Luigi, here I come!"

I also have to worry about how far this could go. What if electricity does clearly improve brain performance? Can't you just see pushy parents wanting to plug their kids in to get a better SAT score? Or a med school gunner wearing some shockware into a test, disguised as earplugs?

This could end up as the academic equivalent of athletic steroids. The next cheating scandal could be some guy tossed out of a math competition for illegal wiring.

Lance was stripped of his high school math letters when it came out he'd been "volting."

So, in closing, my point is this: low-level trans-cortical electrical may have medical utility (personally, I suspect it does). But if that "may" makes you want to shell out more money just to beat your brother at Grand Theft Auto V, then I've got some buildings in Rungholt to sell you.

"Superman warned me the electrodes would do this. Why didn't I listen?"

Thank you, SMOD!