Quote of the day

"Since my back injury I've had trouble going down. On stairs, I mean."

Foot, meet mouth

My 2:00 patient yesterday was obviously blind. She had the long white cane, and a guide dog. Mary filled out forms for her. She held onto my arm as I led her back to my office.


Dr. Grumpy: "So what can I do for you?"

Mrs. Two: "I was at the emergency room this weekend. I had a seizure on Sunday, and bit my tongue."

Dr. Grumpy: "Good heavens. Have you ever had a seizure before?"

Mrs. Two: "No. They told me I had another one in the ER after I got there."

Dr. Grumpy: "Where did the first one happen?"

Mrs. Two: "I was in the car."

Dr. Grumpy: "Were you driving?"

Pause.

Dr. Grumpy: "That was a really stupid question, wasn't it?"


She cracked up. It was a few minutes before we could start again.

Thump

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

Mrs. Phleb: "It's been 2 weeks, and I want to know what my labs showed. Nobody called me."

Annie: "Hmmm... I don't see any results in the system."

Mrs. Phleb: "Well, I took the order in. I don't know why they didn't send them to you."

Annie: "What lab did you go to?"

Mrs. Phleb: "The one in your building. I did exactly what Dr. Grumpy told me to do!"

Annie: "That's strange. Usually they're pretty reliable. Did you have the blood drawn right after your appointment?"

Mrs. Phleb: "What blood draw?"

Annie: "They didn't draw your blood? What exactly did you do?"

Mrs. Phleb: "What Dr. Grumpy told me! He handed me the order, and said to take it to the lab downstairs. I did that, and gave it to the girl at the counter. She set it aside to answer a phone call, and was talking to some lady about scheduling. So I left and went to lunch with Ed."

Annie: "You were supposed to wait for them to draw your blood. The lab order is just an order."

Mrs. Phleb: "Well, he should have explained that!"

Overheard in ER this weekend

Dr. Urgent: "What do you take for your asthma?"

Mr. Wheezy: "Methadone."

Sunday night call check-out

Dr. Grumpy: "Next is a lady in room 835 who I saw for diabetic neuropathy. I started her on Qualex, and..."

Dr. Brain: "Any exam findings?"

Dr. Grumpy: "No reflexes in the legs, and impaired pin & proprioception in the feet. I ordered some labs..."

Dr. Brain: "Proprioception? Don't you mean 'passive joint position sense'?"

Dr. Grumpy: "Okay. In room 753 is a guy who came in with an acute stroke..."

Dr. Brain: "Wait, this is important. You aren't answering my question. 'Passive joint position sense' is a much more relevant term, and you really should use it."

Dr. Grumpy: "Whatever. Anyway, the guy in 753 is weak on the right. I started him on Aspirin, and an MRI is pending. You'll need to..."

Dr. Brain: "So why do you say 'proprioception' ? The correct term should be 'passive joint position sense."

Dr. Grumpy: "Because it's shorter. In room 734 is a lady with seizures who..."

Thursday night phone message

"Hi, this is Austin, and I'm in the twin's class at Wingnut school. My Dad says he'll get me a new XBox game if I take a girl to the junior high dance, so can you please have Marie call me? Thank you."

Statistics

Rikki Phoneysmile, my least favorite drug rep, came by. I went up to sign for samples.


Rikki: "Now... just tap next to the pill strength you'd like, and sign here..."

Dr. Grumpy: "Okay." (signs off, hands iPad back).

Rikki: "Thank you, doctor. I'd like to leave you with this booklet about Dioxnyl to review..."

Dr. Grumpy: "You've left it with me before. You've been handing it out for over a year."

Rikki: "No, it's a new one. We recently discovered an error in that booklet, and it's now been corrected."

Dr. Grumpy: "What was wrong?"

Rikki: "On the efficacy graph we had the drug vs. placebo curves switched. So it made it look like the placebo was more effective than the drug."

Pause

Dr. Grumpy: (giggling) "Your company has been using a booklet erroneously showing your drug was worthless for over a year and no one realized it until now?"

Rikki: "Um, yes. Have a nice day." (drops booklet on desk, leaves)

Mary: "Did you ever notice that?"

Dr. Grumpy: "Hell no. But it's nice to know nobody else reads them, either."

Texting by voice

Marie's Wingnut School girls basketball team had their first win of the season yesterday, and Mrs. Grumpy sent me the results. So I was trying to get Siri to text "Yay!" back.

Yes, we are

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

Mrs. Chart: "Hi, I have an appointment next week, and I need you guys to get my records before then."

Mary: "Okay, but we can't get your records from other places. You need to contact them, and fax a release."

Mrs. Chart: "I've seen 3 other neurologists, and been admitted to 2 hospitals for my problems. I'd think you'd want to have their notes."

Mary: "Yes, the doctor would, but again, you'll need to contact them and have them send records. We can't get them without a release. You can come in here and sign one, or I can fax one to you."

Mrs. Chart: "I don't have time for that. I'm busy. You need to just call them yourself. You can tell them I told you to."

Mary: "Ma'am, it doesn't work that way. There are privacy laws and..."

Mrs. Chart: "Oh, you're one of those practices. Never mind."

Thursday afternoon

Dr. Grumpy: "How long have you been taking Fukitol?"

Mr. Vague: "Um, since I started it."

50 Shades of Neurology

Seen in a hospital chart:

Nudge, nudge, wink, wink, say no more!

We deliver

I needed to mail a chart to another office, which, for whatever reason, doesn't have a working fax this week. So on the way home yesterday I stopped at the post office.


Postal clerk: "That will be $5.21... Thank you. Where are you mailing this to, sir?"

Dr. Grumpy: "Lakeside Grumpyville, about 5 miles north of here, near Main & 28th street."

Postal clerk: "Under security precautions a package of this size cannot be put on a plane, so it will have to go by ground delivery with consequent delay. Will that be ok?"

Dr. Grumpy: "Um, yeah."

Memories...

The university where I went to medical school had a large indoor gym. All students were allowed to use it, but you had to show a student ID to get in. This is pretty standard.

What wasn't standard was Weather Guy.

To this day I don't know what his name was. He never wore a name tag. He was a pleasant, elderly fellow whose sole job was to sit there and check ID's before letting you into the gym.

I have no idea where the school found Weather Guy. For all I know he'd lived on the land when the school was started in 1868, and they built the gym around him and gave him a job. He was never NOT there. Weekends, nights, early mornings, holidays - I don't remember ever seeing anyone but Weather Guy working the gate. Neither did my roommate. Or professors who'd graduated from the school before I was born (the gym building, I believe, predated exercise). For all I know he lived at the entrance desk, and had a cot behind it.

But his most enduring feature was the one that gave him his name: a remarkable inability to discuss topics other than the weather. Nuclear war in progress? Let's talk about the weather. Super Bowl upset? Let's talk about the weather. Flaming car wreck outside the gym? Let's talk about the weather.

Now granted, a LOT of people ramble pointlessly about the weather. This is nothing new. What set Weather Guy apart was his lack of awareness for such.

In retrospect, I'd say he was fairly demented. It didn't take much effort to look at a plastic card and say "go on through." In fact, it would explain why he passed pretty much anyone with a plastic card, whether it was a student ID, credit card, drivers license, or Local Grocery rewards card.

So as you'd go through the line, he'd always say something like "It must be cold out there" or "it's a scorcher today." He'd say this regardless of season, so it was equally likely to be the dead of winter or blazing summer heat, and he'd have a 1-in-4 chance of being in the ballpark.

Of course, this sort of thing couldn't go ignored by college students.

There was a summer day when it was the typical hot & humid, with mosquitoes the size of dinner plates. I was in line behind a guy, and as he walked up Weather Guy guessed right and said "Gonna be a hot one."

This fellow, instead of saying the usual "uh-huh" and moving on, said "Actually a snowstorm just started. It's freezing!" And then went into the gym.

Weather Guy didn't bat an eyelash. As I came up to the counter and took out my ID, he said "It must be cold outside. I hear it's snowing."

On call, Sunday morning

 Overheard at the nurses station at 7:53 a.m.:

"So far we've had 2 try to escape, 3 wander out buck naked, a lady in DT's screaming about spiders, 4 calls to security, the lady in 17 smoking weed in the bathroom, the guy in 24 masturbating in the hallway, and it's not even fucking 8:00 yet."