Memories...

Dr. Balboa was a cardiologist at my medical school. He was good at what he did.

Unfortunately, he also had a confrontational personality, short temper, and complete inability to back down from conflict. These are not good traits to have when you're just over 5 feet tall, slender, and have absolutely no training in Karate/Kung Fu/Krav Maga/whatever.

So, on a relatively frequent basis, the hospital ER docs were used to sewing him up for injuries sustained in bar fights, traffic altercations, or any number of minor arguments that he escalated to stupid levels.

One night, during my 4th year cardiology rotation, I was also covering an ER shift for a friend who needed to trade. And, of course, Dr. Balboa came in. He'd been at a sports bar and the waitress accidentally knocked over his drink. Rather than accepting a replacement, he decided to hash it out with the bouncer. Which is never a good idea.

Since the inner-city ER was swamped, he was stuck with having me sew him up (or wait a few hours for a real doctor, or go to another ER). Hey, it wasn't something I wanted to do either, but I was stuck.

So, while I'm trying my best to professionally put in stitches, he began telling me what I was doing wrong, grilling me about the patients on our cardiology service, pimping me on side effects and half-lives of various drugs, and arguing with no one in particular about how today's medical students weren't as tough as they used to be. None of which helped keep me focused on the job at hand.

After he was discharged, I went back to the staff lounge to get some coffee. The window there looked over the parking lot. As I watched, Dr. Balboa went out to his BMW and began arguing with a guy who'd set a Gatorade bottle on its roof.

Five minutes later he was back in triage with a broken wrist.

Verbiage

Back in the early, sexist, 80's, I had a teacher who'd say "writing should be like a girl's skirt: long enough to cover the subject, short enough to keep it interesting."

Now, times and expressions may have changed, but his point is still well-taken. This was driven home to me recently while reading an article about the effects of concussions on college football players.

I'd have to say the gentleman on the right nailed it:

Sunday night call check out

Dr. Grumpy: "Next one, in room 734 is Mr. Spin, admitted for severe vertigo. I think it's peripheral, but ordered an MRI and..."

Dr. Nerve: "What kind of vertigo?"

Dr. Grumpy: "Positional vertigo. It happens when he turns his head left."

Dr. Nerve: "Which of the semicircular vestibular canals is involved?"

Dr. Grumpy: "Are you serious?"

Dr. Nerve: "Yes. Which canal is involved? Superior, Horizontal, or Posterior? They taught you that in residency, didn't they?'

Dr. Grumpy: "I have no fucking clue. I had 29 consults this weekend, and breaking that down isn't going to change my management."

Dr. Nerve: "I think these things are important."

Dr. Grumpy: "I don't when I'm swamped. On call my main question is whether it's central or peripheral. You want more than that, call an ENT."

Dr. Nerve: "Personally, I examine them closely until I've localized the canal."

Dr. Grumpy: "You do that. He's in 734. The MRI is pending. The next patient is..."

Erev Independence Day

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

Ms. Triptan: "Hi, I need to get in to see him tomorrow. My headaches have gotten worse."

Mary: "We're closed tomorrow. It's a holiday."

Ms. Triptan: "But this is important. I'm really miserable, and need something done! Couldn't he meet me there? Just for a short while?"

Mary: "No, but we had a cancellation for today, at 4:15. He can see you this afternoon."

Ms. Triptan: "I can't do that, I'm going to the casino. It's Bonus Slots Thursday."

Help wanted

You need to have brain surgery. Wouldn't you want a surgeon who had experience in the field (as opposed to, say, removing ingrown toenails)?

Me, too.

So, this is an interesting job ad. A hospital is looking for an anesthesiologist. That's the person in charge of making sure you're deeply out when they cut you open, watches your vital signs to make sure you're not dying on the table, and then (hopefully) wakes you up after the surgeon has put you back together.

So shouldn't they want someone who'd previously done that a few times?

Apparently not:

Yes folks, you read that correctly. They want an anesthesiologist, but experience using anesthetic drugs and procedures is "preferred" though not, say, "necessary" or "required" or "a really good idea."

Let's look at it this way:


Astronaut wanted to fly large rocket full of highly explosive fuel at 17,000 miles per hour to International Space Station. Experience at operating rockets preferred.

Scientist needed to calculate origins of matter and to evaluate data relating to Higgs Boson. Experience with physics preferred.

Person needed to maintain nuclear warheads. Experience with handling lethally radioactive materials with potential to wipe out a city preferred.


Now, realistically, I'm aware it would be hard to become a board certified/eligible anesthesiologist without actually doing the procedures and giving drugs... but you never know. I trained with a guy who got through a 3 month surgical rotation without ever setting foot in the OR. And he passed.


Thank you, Jess!

Full service neurology

I'm between patients when Mary tells me a doctor is on hold.


Dr. Grumpy: "This is Dr. Grumpy."

Dr. Veoli: "Hi, this is Al Veoli, the pulmonologist across the street. We have a mutual patient, Don Epazil, who you're seeing for memory problems?"

Dr. Grumpy: "What's up?"

Dr. Veoli: "I'm not sure what to do here. I guess he was going to haul his clothes to the cleaners, but got the addresses mixed up. He took the bus here, and now he's out in the waiting room, trying to give bags of dirty duds to my staff."

Dr. Grumpy: "I'm sorry. His son lives with him, but is out of town this week. Tell him to come over here. I'll call his sister, who's handling this stuff."

Dr. Veoli: "He's showing stains to people in my lobby asking how to get them out. One nice lady is trying to give him pointers. I don't think she realizes what she's dealing with."

Dr. Grumpy: "Okay. Direct him here, and I'll give his family a ring."

Dr. Veoli: "Thanks. Sorry to bother you."

10 minutes later

Mary: "Hey, doc, Mr. Epazil is up front with 3 bags of dirty clothes. He says he was supposed to bring them here to have them done? Laundry WAS NOT in my job description."

Perspective

My daughter left her hairbrush on the kitchen counter last night.

That's not a big deal, but when I first walked into the kitchen, this is what I saw:

Sunday night, 11:23 p.m.

The following message was left on my office voice mail last night:

"Hello, I'm a patient of Dr. Grumpy's. It's Sunday night, about twenty minutes after 11:00, and I'd like someone to call me back. Thank you."

That's all. Never called back with anything more helpful, like a name or phone number.

Random weekend pictures

All right, time to hit the e-mail bag of stuff you guys have sent in.


First, this was taken at an art museum in Budapest (it's actually the name of the artist being featured).

"On your right is the Sheriff Jim Clark display, and in the next hall are Ernst Zündel's works"

Next, we have this. Apparently telling someone to "go pick up paper towels" at the store is no longer enough. I had no idea the world needed this many varieties. I mean, IT'S A FUCKING PAPER TOWEL!!!

7 varieties of paper towels. For this we evolved from microbes.

Then there's this massage company, who probably should have thought out their logo a bit more carefully:

"The pun sucks, too."

Speaking of interesting signs, I have no idea what this means:

"The counter lady yelled at me. Maybe they mean bitches."

The box makes it sound like they sing, dance, and perform theater:

"I'm trying to eat, and my fork keeps doing the Macarena."

Next is an ad for a group that does bio-identical hormones. The name sounds like they're all clones.

"Did you want to see Dr. Grumpy, Dr. Grumpy, or Dr. Grumpy?"

And last, I have no idea why this company couldn't come up with a better way to say "non-allergic pet food"

"Which end of Fluffy do we put it in?"

Great Public Service Announcements

Whirrrrrrrrrrrrrrrrrrrr

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mrs. Sikorski: "You saw my daughter yesterday? I was at the appointment if you recall, and you started her on Migrazap?"

Dr. Grumpy: "Yes, I remember. Is there a problem with the medication?"

Mrs. Sikorski: "No. I'm calling because she drove back to college today, and I don't think she's getting enough sleep."

Dr. Grumpy: "Well, the medication won't affect sleep, so it..."

Mrs. Sikorski: "That's not the issue. I need you to call her and discuss how important sleep is, because it's going to affect her grades. She also needs to study more."

Dr. Grumpy: "Well, that's not really my place. I mean, she's 21 years old, and away at college, and..."

Mrs. Sikorski: "Could you at least bring it up at her appointment next month? Also, can you say a few words about her current boyfriend? I don't think he's good for her."

Annie's desk

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

Mr. Valproate: "I want to know why the doctor won't refill my seizure meds!"

Annie: "Let me see... I don't show that we have a request for that. Did you call your pharmacy?"

Mr. Valproate: "Yes! They told me they've sent it to Dr. Intern 3 times, and all she does is say that she doesn't prescribe my seizure meds. So why won't Dr. Grumpy refill it?"

Annie: "Why are they sending it to Dr. Intern? Did you ask them to fax it to Dr. Grumpy?"

Mr. Valproate: "No. Am I supposed to?"

Memories...

As readers know, my roommate for all 4 years of medical school was a guy named Enzyme.

Enzyme was about 6'3" and maybe 190 lbs. He was calm, cool, and confident, the perfect model of the U.S. Navy officer that he is today. Handsome and a ladies man. He knew how splendid he looked in his uniform. He loved the military, and didn't let anything alarm him.

Until one night.

It was, maybe, around 2:00 a.m. I'd gone to bed at midnight after giving up on studying for the day, and was in a deep sleep.

While I slumbered, deeply napping, suddenly there came a tapping, as of someone gently rapping, rapping at my bedroom door.

Med student Grumpy: "Hello?"

Enzyme: "Ibee, are you awake?"

Grumpy: "I am NOW. What's up?"

(silence)

Grumpy: "Are you okay?"

Enzyme: "I... Need your help."

Grumpy: "It's 2:00 a.m. What's going on?"

(silence)

Grumpy: "Enzyme?"

Enzyme: "There's a spider in my room."

Grumpy: "What?!!!"

Enzyme: "I said there's a spider in my room."

Grumpy: "What the hell? So squash it and let me sleep."

(silence)

Grumpy: "Hello?"

Enzyme: "I'm scared of spiders."

It wasn't even that big, FFS.

"Are you shitting me?"

Awesomeness

For those of you who don't follow Twitter, I'm going to have to put this up.

My random observation was good. But WhiteCoat's response made it great: