Wednesday, December 3, 2014

Head desk

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

Dr. Hospital: "Hi, I was wondering if you got a consult on Mrs. Weirdlastname?"

Dr. Grumpy: "I don't remember, but I got a lot of calls last night. Hang on, let me get my list out."

Dr. Hospital: "I was hoping you could see her soon, because she wants to catch her flight to Calgary later today."

Dr. Grumpy: "Okay, I have my list. How do you spell it?"

Dr. Hospital: "Uh, C-A-L-G-A-R-Y."

Tuesday, December 2, 2014

Brave New World



Source: "Accountable Care Organizations Aim to Provide Better Health Care" Neurology Reviews, September, 2014.

Monday, December 1, 2014

Dr. Grumpy's gift guide

Yes, as the calendar begins its countdown to Christmakuh, it's once again time for the gift guide. Where Dr. Grumpy will help you pick out the finest in tasteful, fashionable, and useful items.

This year, I'm going to kick things off with a solution to a common problem: What to do with a dead rodent.

You've finally killed that pesky mouse that was terrorizing your kids and less-than-impressive dog or cat... but now what? I mean, it seems like a pretty long walk to take it out to the trash can. And after he was kind enough to jump-start your car you really don't want to toss it into the neighbors yard, either.

So why not make it into a lovely decorative piece?


"Well, it beats the leg lamp you imported from Fragilé."

Yes, for only $47 you can give a loved one the complete Mouse Taxidermy Kit. It includes instructions and materials, you just have to supply imagination, props... and, of course, an ex-mouse.


"Do they sell one in St. Bernard size?"

Start a new pastime with the passed-on. It's sure to be a fine conversation piece for a living room, cubicle, or dashboard.

Friday, November 28, 2014

Black Friday deals


Black Friday reruns

Quartzsite, Arizona is a small town along U.S. Interstate 10, and many just stop there for food and gas on the way to other places.

In the local cemetery is a small pyramid with a copper camel on top, marking the grave of a mostly forgotten man named Hadji Ali.






Very little information about his background is known. He was born in 1828 in what was then called Greater Syria (today that includes Syria, Israel, Lebanon, and Cyprus). His parents were likely Bedouins. He was Muslim.

What is known is that he played a central role in what's now a mostly forgotten (but well worth remembering) episode of American and Canadian history.

The idea was first proposed in 1836, but wasn't taken seriously until 1848. Following the Mexican-American war, the United States found itself in control of a large desert, covering what's now New Mexico & Arizona, along with parts of Texas, California, Nevada, and other states. The U.S. Army needed to establish bases and supply lines in the area, both for the border with Mexico and the continuing wars with Indian tribes.

The railroad system was in it's infancy, and there were no tracks through the region. It's part of the largest desert in North America. The only way across was to use horses. But horses, like humans, are heavily dependent on water. This made the area difficult to cross, and vulnerable to attacking Apaches.

So in 1855 Jefferson Davis, then U.S. Secretary of War (later to become President of the Confederacy), put into action an idea proposed by several officers: buy camels to serve in the desert. Congress appropriated $30,000 for the endeavor, and officials were sent to Turkey to do just that.

Between 1856-1857 the U.S. Army bought roughly 70 camels, transporting them from Smyrna, Turkey to Indianola, Texas. To handle them they brought over 8 camel drivers, with Hadji Ali in charge.

The camels worked remarkably well... To a point.

They were perfect for the environment. The huge southwest desert didn't faze them. They led supply trains all over, from Texas to California. With their low need for water, and bodies specially adapted to arid environments, they easily crossed areas where horses and other pack animals couldn't.*

But there were problems. The Americans had envisioned combined forces of camels and horses, each making up for the deficiencies of the other. But horses and donkeys are frightened of camels, making joint convoys difficult and requiring separate corrals. The army was also unprepared for their intrinsically difficult personalities- camels bite, spit, kick, and are short-tempered. Horses are comparatively easy to handle.

With the start of the American Civil War, the U.S. Army Camel Corps was disbanded. Troops and horses were needed on the east side of the country, while camels weren't. Most of them escaped into the desert, and thrived there for a while. In an attempt to preserve them, the Arizona territory  outlawed camel hunting.

But the camel story didn't end there. One of the soldiers, Frank Laumeister, saw business opportunities in Canada. He bought a herd, and in 1862 took them north to British Columbia. The Cariboo gold rush was in progress, and pack animals were needed.


Canadian prospectors and a friend


The results in Canada were mixed. The camels were strong, and could carry twice as much as mules. But their broad feet, while perfect for the sand and dirt of the desert, were cut up by the rocky terrain of the Pacific Northwest. It became necessary to make special protective shoes for them (given their difficult nature, it's unfortunate that history hasn't recorded how they responded to having shoes put on).

The Canadians, like the Americans, discovered they weren't easy to handle. The same problems of difficult disposition and spooking horses came up. In addition, they found camels would eat anything they found. Hats. Shoes. Clothes that were out drying. Even soap. And so, after a few years, the Canadians gave up on the experiment, too.

But they weren't forgotten. A mountain range in British Columbia is called the Camelsfoot. The town of Lillooet has "The Bridge of the 23 Camels". A geographical basin is called "The Camoo".

Some camels were sold to farms. Others escaped into the wild. One was mistaken for a grizzly bear (WTF?) and shot, ending up briefly on a local bar's menu.

The last reliable sighting of a wild camel in Canada was in British Columbia, in the 1930's. The last sighting in North America was in Douglas, Texas in 1941- 85 years after the first ones had landed.

Two fiction movies have been based on the North American camel experiences: "Southwest Passage" (1954) and "Hawmps!" (1976). There's even a folk song called "Hi Jolly!" about them.

And what became of Hadji Ali?

His American hosts had trouble with his name, and pronounced it as a greeting: Hi Jolly! After the camel business shut down he decided to stay here, becoming a citizen in 1880. He tried his hand at several business, and married a woman named Gertrudis Serna in Tucson. They had 2 children. At some point he changed his name to Philip Tedro, but "Hi Jolly" is the name that stuck with him, and is on his Quartzsite tomb.


Hadji Ali and Gertrudis Serna


He prospected around the southwest U.S., occasionally working for the army. Once, when offended that he hadn't been invited to a friend's party in Los Angeles, he broke it up by repeatedly riding through it in a wagon pulled by 2 of his remaining camels.

He spent the last years of his life in Quartzsite, Arizona, dying in 1902. His adventures had impacted 2 countries and covered 3 continents. It had been 51 years since he'd left his native Middle East in one of the strangest military projects on record.

*Technically, it should be noted that camels are originally from North America. Really. Their ancestors evolved in North America 23-40 million years ago, but left. One group went west into Asia (then down to Africa), several million years ago, over the Bering Strait Land Bridge, evolving into today's camels. The rest migrated to South America 3 million years ago when the Isthmus of Panama formed, and became llamas and alpacas.

Thursday, November 27, 2014

Scrolling through Groupon

While I have nothing against vibrators, or Groupon, I did get the giggles over how they're mixed in with more mundane household items.

They were also selling, on DVD, the complete TV series "Highway to Heaven." Regrettably, that pic wasn't next to one of these ads, or it would have been perfect.




Anna and Elsa know what they want for Christmakkuh...

Wednesday, November 26, 2014

Tuesday afternoon

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

Mrs. Concern: "Yes, I need to make an appointment for my husband."

Mary: "Okay, we can see him next Tuesday at..."

Mrs. Concern: "That's not acceptable. We need to be seen urgently, this afternoon. We're flying to visit our children in the morning. It's Thanksgiving this week."

Mary: "Yes, ma'am, but we're entirely booked today and Wednesday, and closed the rest of the week. But next Tuesday we have..."

Mrs. Concern: "We can't wait until then. He's had a stroke."

Mary: "When was his stroke?"

Mrs. Concern: "Sometime during the night. He's had trouble using his left side today, and his speech is slurred. And now my back hurts, because with him like this I had to do all the packing for both of us."

Mary: "Ma'am, you need to take him to the emergency room. I know Dr. Grumpy is going to tell you to do that. Immediately."

Mrs. Concern: "Nonsense. They'll just do some expensive tests and put him in the hospital. We have a flight in the morning, and can't miss that. We're going to visit our children. I just want to have Dr. Grumpy check him over before we leave."

Mary: "You really need to take him to an emergency room."

Mrs. Concern: "Our internist's office told us the same thing. I can't say I like the attitude you people in 'modern medicine' have these days."

Mary: "I'm sorry but..."

Mrs. Concern: "I hope you realize you're ruining our Thanksgiving."

Tuesday, November 25, 2014

Doublespeak

This is from a letter an insurance company sent to one of my patients about having an MRI:


So, let's translate this:

1. It's okay with us if you have an MRI.

2. We may pay for it. Then again, we may not. We won't decide until AFTER you actually have it done.

3. If, after we get a bill, we decide not to pay for it, you will have to pay for it.

4. If we do decide to pay for it, you'll still likely have to pay part of the bill. How much this will be will depend on what we decide. We'll let you know after you've already had the test.

5. Once you get the test, you have absolutely no say in the matter. We, on the other hand, can change our mind at any time.

Monday, November 24, 2014

Sunday morning, 3:48 a.m.

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

Mrs. Wokemeup: "Hi, I'm a patient of Dr. Cortex. He has me on Ataxizon 500mg twice a day. Anyway, for the last week I've had a lot of balance problems. He did labs on Thursday, and said my Ataxizon level was way too high."

Dr. Grumpy: "Okay."

Mrs. Wokemeup: "So he told me to lower the dose to 400mg twice a day. But my balance is still terrible, and I don't know what to do."

Dr. Grumpy: "So you're on 400mg twice a day of Ataxizon right now?"

Mrs. Wokemeup: "No, I take 500mg twice a day."

Dr. Grumpy: "Wait... I thought you said Dr. Cortex told you to decrease the dose because it was affecting your balance?"

Mrs. Wokemeup: "He did. But I wasn't sure if I should. I thought I'd see what someone else thought."

Saturday, November 22, 2014

Home moments

Discovering your kids are playing Star Wars... and have dressed the dog up to be Luke Skywalker.



Friday, November 21, 2014

Sigh

Dr. Grumpy: "Why are you taking Lithium? Are you bipolar?"

Ms. Valence: "No, I'm Puerto Rican."

Thursday, November 20, 2014

Crystal ball

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

Ms. Seance: "I need to get an appointment right away! I have a brain tumor!"

Mary: "Okay, we have an opening Thursday, at..."

Ms. Seance: "It's an emergency! I have a brain tumor!"

Mary: "Where did you have your MRI? I can try to get that report for the doctor."

Ms. Seance: "I haven't had any tests. Look, this is serious! I have a brain tumor!"

Mary: "Huh? You haven't had any tests? Then how do you know...?"

Ms. Seance: "My medium told me!"

Mary: "A medium told you..."

Ms. Seance: "Yes! And she's never wrong! The spirits told her that I have a brain tumor!"

Mary: "Okay. Well, we can see you Thursday, at 2:30. What insurance do you have?"

Ms. Seance: "CrappyCare, Inc."

Mary: "I'm sorry, we're not contracted with CrappyCare."

Ms. Seance: "But my medium said you are!"

Mary: "We've never been with CrappyCare. Let me give you some phone numbers..."

Ms. Seance: "This is my medium! She's never wrong! You must be!"

Wednesday, November 19, 2014

Elevator talk


It's 5:15 a.m. The first group of docs is drifting in for the day. I grabbed a Diet Coke and got in the hospital elevator. The doors were closing when one of the hospitalists, trying not to spill his coffee, called for me to hold it. So I hit the "open" button.

Dr. Med: "Morning, Ibee. Thanks for getting that."

Dr. Grumpy: "No problem, Jack. Where you starting?"

Dr. Med: "Ummm, I guess 8 would be best. Can you push that? Thanks."

Dr. Grumpy: "Sure. Hey, are you going to send Mrs. Stroke home today? Her dopplers looked fine."

Dr. Med: "Yeah. She's on Plavix, and I'll have her follow-up with you in 2-3 weeks."

Dr. Grumpy: "Sounds good."

Dr. Med: "Recently I've been getting headaches, but only when I'm masturbating. Should I be concerned about that?"

Next time I'm not going to hold the door.

Tuesday, November 18, 2014

Run that by me again

Seen in another doctor's note:


 
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