Monday, April 7, 2014

Seen in a hospital chart:




So, based on this detailed exam, we can assume which of the following:

The patient...

A. Is dead, and the doctor is in the morgue by mistake.

B. Has escaped, and left a mannequin in the bed.

C. Is a parrot.

D. Wait, how the hell is that part of a mental status exam?

E. The doctor billed this as a level 5 visit.


Friday, April 4, 2014

Quote of the day

"I take a blood pressure pill, or maybe it's for my cholesterol. Actually it might be a blood thinner. Anyway, it's one of those."

Thursday, April 3, 2014

Pathology

Dr. Grumpy: "Any major illnesses in your family?"

Mr. 12A: "No."

Lady 12A: "Your mom had diabetes."

Mr. 12A: "Is that major?"

Lady 12A: "I think it's major."

Mr. 12A: "I don't."

Lady 12A: "What do you consider major?"

Mr. 12A: "Where did you go to medical school?"

Wednesday, April 2, 2014

Poke into others as you'd have poked into you?

Ya know, I heard the Golden Rule a lot in childhood, but don't remember this part of it...


Gives a new meaning to "the Midas touch," eh?

Thank you, BW!

Tuesday, April 1, 2014

Why I do what I do

It's been 4 years since I last ran this piece, and I think it's worth putting up again.


It ain't much to look at.

Two, maybe three pounds of grayish-white goop. It's not even solid in a living person. More like Jello that floats around in it's vault.

But it's amazing. From that sloppy goop has come remarkable stuff. It's sent a robot to land on a moon of Saturn. It's explored the bottom of our deepest oceans. Built the Taj Mahal. The Great Wall of China. Painted the Mona Lisa.

Go listen to the remarkable Bach's "Toccata and Fugue in D minor". Not just the famous opening 30 seconds or so, but the whole 9-10 minute thing. That all came from the goop, long before it was heard or played on an instrument, it was just a series of electric signals jumping from nerve to nerve. The piece is over 300 years old. The mind that created it has been dead for over 250 years. And humans will likely be listening to it long after my great-great-great-grandchildren are dust.

The soul is there. The heart is amazing, but for all our romantic beliefs about it, who we really are is floating around in the goop. It's where hate, love, and everything in between comes from.

It's capable of terrible evil, such as the Holocaust, and remarkable good. Look at the outpouring of altruism that follows disasters. I love my dogs, but if something bad happens to a dog on the next street, they're not going to care. Yet the goop wants to help people who we've never met and have no direct impact on our own lives

My regular readers know I'm interested in maritime history. Why? I have no idea. It's just been a subject I've loved as long as I can remember. I've never been in the navy. The family military history consists of grandparents who served in the army, but never were sent overseas. I can only assume there is some particular molecular structure in my goop that makes me interested in it. Or that made me want to treat other people's goop for a living.

Twin and biological studies have shown that most of who we are is how we came here. Yes, life experiences and background count for something, but the goop is most of it. People with conservative beliefs raise kids who turn out to be liberals, and vice versa, no matter how hard they may try to pass on their beliefs.

Coke vs. Pepsi. Dogs vs. Cats. Mac vs. Windows. I suspect whatever makes us fall on one side or the other of these great philosophical issues is 95% or more in the goop, and we just come that way.

Everything you are, have been, and will be. Have desired, dreamed of, and done. Have felt. It all comes from a few pounds of goop.

And this fascinates me. Because, let's face it, we're just another part of the planet. A collection of complex molecules, electrical impulses, and chemical reactions. That's all people. Anatomically, all humans are pretty much the same. And we're not that different from other mammals. The difference in our genetic sequence vs. that of a mouse ain't much.

And yet that small amount of difference has led to amazing results. The ability to think beyond our own biological needs and to see the world around us for the beauty it contains. To watch a sunset and be in awe, even though we understand the science behind it. And to look up at the night sky, and wonder.

And that never bores me.

Monday, March 31, 2014

Mary's desk

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

Ms. Urgent: "I need to see your doctor right away! My doctor told me to call you guys!"

Mary: "Well, he's out of town this week, but next week we can see you on..."

Ms. Urgent: "Well, how far away is he? I mean, like where he could drive back tomorrow to work me in?"

Mary: "No, he's gone until next week. Now..."

Ms. Urgent: "But I need to see him! Doesn't he have a partner or something?"

Mary: "No, we're a solo practice."

Ms. Urgent: "What about you? Can I see you? You work there."

Mary: "I'm a secretary, ma'am."

Ms. Urgent: "But still, you must have learned enough just from working there!"

Mary: "No. Anyway, next week we have..."

Ms. Urgent: "I could be dead by next week! And don't tell me to go to ER, either! I'm tired of going to ER's. Why isn't the doctor there, anyway?"

Mary: "He took his kids to go visit family. Now, we can..."

Ms. Urgent: "You mean he goes on vacations? What the hell? Doctors shouldn't be allowed to do that! They trade that in to care for people!"

(hangs up)


Monday, March 24, 2014

Spring break

Due to my kids having this week off, we're going to visit family in warmer weather. I will return on March 31, 2014.



Friday, March 21, 2014

Quote of the day

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

Thursday, March 20, 2014

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.

Wednesday, March 19, 2014

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!"

Tuesday, March 18, 2014

Overheard in ER this weekend

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

Mr. Wheezy: "Methadone."

Monday, March 17, 2014

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..."

Friday, March 14, 2014

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."

Thursday, March 13, 2014

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."
 
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