Loyalty

Mary interrupts me while I'm with a patient. Never a good thing.


Mary: "There's a doctor on the phone, says he needs to talk to you right now."

She hands me a piece of paper. I pick up the phone. It's a guy I've never heard of.

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

Dr. Interruptus: "Hi, this is Cody Interruptus, I work over at the Local Hospital clinic, and I've got a guy here... 27 years old... anyway, he has Flehner-Lathrop Syndrome, and I think he needs to see a neurologist soon, if you could work him in."

Dr. Grumpy: "That's pretty uncommon, and I've never seen a case. Have you called Ivory Tower Neurology? They have a lady who specializes in it."

Dr. Interruptus: "No. I mean, I'm part of the Local Hospital clinic, and would like to keep the patient here, seeing other docs who work out of Local Hospital. In this day and age we all need to work together and support each other in the community. I'd appreciate it if you could help me out. I mean, you can refer him to Ivory Tower afterwards if you need to."

Dr. Grumpy (feeling guilty): Okay... I'll work him in over lunch tomorrow."

Dr. Interruptus: "Thank you."

Dr. Grumpy: "Let me get his info... Looks like Mary wrote most of it down... What insurance does he have?"

Dr. Interruptus: "Sickness & Wealth HMO."

Dr. Grumpy: "Oh... I'm sorry, I'm not contracted with S&W. I never have been. Two of my call partners, Drs. Brain & Nerve, are, let me give you their number..."

Dr. Interruptus: "But this is LOCAL HOSPITAL. Those two work out of OTHER HOSPITAL. You need to help support us and the Local Hospital community. Can't you just see him for free?"

Dr. Grumpy: "He has insurance. This is not a charity issue. I do plenty of charity work for the uninsured. I'm not going to see him for free when there are plenty of docs who take his insurance around."

Dr. Interruptus: "You should be loyal to the hospital. That should be your first priority."

Dr. Grumpy: "I..."

Dr. Interruptus: "Thanks for nothing."

(click)

Mary is FIRED!... again.

Recently, who knows why, the twins have become obsessed with the 1984 Lionel Richie song "Hello."

And by obsessed, I mean singing it to the dogs, to each other, in the car, playing it on their phones, playing it on their band instruments... pretty much UNTIL I WANT TO KILL THEM.

Anyway.

The other day I was bitching about it to Mary, and how damn sick I was of hearing it.

The next morning I was in a room examining a patient, and afterwards walked back to my office. When I sat down to type up some notes, my mouse wouldn't track. It had been working fine earlier.

After a minute I turned it over to see what was wrong, to find this taped to the bottom:

Mary's desk, January 19, 2015

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

Mr. Ecgonine: "I need to get checked out by the doctor right away!"

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

Mr. Ecgonine: "No! This is an emergency! I was snorting cocaine this morning, and my eyes started twitching. It must have made me catch cerebral palsy or Down Syndrome or something like that, and I need to get screened for all of those things."

Mary: "Well, I..."

Mr. Ecgonine: "Not only that, but I think I have some sort of cancer. Like lung cancer, or leukemia, or brain cancer, that kind of stuff, and I need to get screened for all of those, too."

Mary: "Okay, but..."

Mr. Ecgonine: "Hey! My dog just peed in the kitchen!"

The line went dead.

Huh?

Seen in a medical market research survey last week:

Weekend reruns

The phones were really ringing today, and so a few calls went to voice mail. Annie had me listen to this one:

"Hi, this is Suzy Frazzled. I'm a social worker involved in the medical case of Kathy Smith. I'm calling to see if you have any records on her. You probably don't, because none of the other doctors on the list she gave me have ever heard of her, either, and I'm on my last damn nerve dealing with her. Anyway, she's blaming every freaking illness she has on a piece of cotton that was left in her ear 2 years ago after she had a glob of wax taken out. Thinks she's won the freaking lottery, apparently. What? No Bob, I don't have that info here. I've been working on Mrs. Smith all damn morning. How come you don't get these cases? The boss gives me all this shit, and it's not fair. Where the hell do these people come from and why do they always end up on my desk? Why can't I get normal cases? Oh, sorry, hello? Anyway, please call me back and let me know if you've ever heard of this lady."

Sigh

Dr. Grumpy: "Which orthopedist did you see?"

Mr. Vague: "He works over on the south side. It was a Dr. Hansen, or Martin. Maybe it was Stevens or Smith. It could have started with an 'S', but I'm not sure. You know who I'm talking about, right?"

Memories...

A long, long, long, time ago, during my college years... I was a volunteer working in an ER.

It was a fairly small ER, and I was allowed to do A LOT of things that volunteers today aren't. It was nice, because my help was genuinely appreciated, and I was made to feel like part of the staff.

Anyway, one day an elderly lady came in with trouble breathing. While the doctor examined Mrs. Gasping, the nurse and I hooked her up to some oxygen. She went to turn on the O2, handed me the oxygen mask, and asked me to put it on the patient.

So I was placing it on the lady's face when the elastic band snapped over, pulling the plastic mask to the side.

To my horror, her whole nose flew off. We hadn't been told she had a prosthetic nose to replace one lost to skin cancer.

The nose clattered over the gurney and onto the floor. I screamed, thinking I'd somehow accidentally torn her nose off. The nurse shrieked. The doctor jumped back. I saw my entire dream of a medical career vanish.

Her husband started laughing, picked up the nose, put it in her purse, and set the oxygen mask on correctly.

I hid in the bathroom for a while.

Better living through pharmacology

2:28 a.m.

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

Mrs. Insomnia: "Hi, my husband sees Dr. Cortex for epilepsy."

Dr. Grumpy: "Is he having a seizure?"

Mrs. Insomnia: "Oh, no. He's fine. He takes Felbacetam."

Dr. Grumpy: "Okay, so why are you calling? Is he out?"

Mrs. Insomnia: "No, we have about 3 weeks left. But it requires an annual authorization from the insurance company to continue, and Dr. Cortex's nurse put the request in last week. Do you know if they've heard anything back yet?"

Dr. Grumpy: "No. Why don't you call his office when they open in the morning and ask?"

Mrs. Insomnia: "That's a good idea. Thank you, doctor. Have a great night."

A rose by any other name

Karen writes in:

"Dr. Grumpy, I've worked at different doctor's offices for over 20 years. But was still surprised when an infusion pharmacy rep came by recently and left his card and company information."

I'm going to have to agree with you, Karen. That's a TERRIBLE name for a pharmacy. Or pretty much any business (I wouldn't have dinner at DikPizza). Unless it's a sex shop.

According to the website, Dik is the owner's last name. And I respect that. Putting your name on a business is pretty universal. It's his name, and he's proud of it. But still, I think you have to take meanings into account, too. If your last name is Shithole or Fukme, you wouldn't want that on your cards. I think, in this case, going with your initials, or first name, or pretty much anything else, would sound better.

It also kind of distracts you from what the business does. I see "DikDrug" and I immediately assume they specialize in Viagra, Cialis, and Levitra "Here's a sample, why don't you see if it works? There's some magazines in the lobby bathroom."

Even more chilling (at least for a guy) is that DikDrug is an INFUSION pharmacy. This brings to mind painful images of Caverject and long needles being stuck in my winkie... I better cross my legs and end the post here.

Thank you, Karen!

Quote du jour

"I'm less aware of forgetting what I can't remember."

Squeeze

Last night I was watching a live CME presentation online. The discussion was about ways to measure stroke recovery by using a hand-grip dynamometer.

At one point the speaker said:


"The affected arm will be tested using a grip dynamometer for hand-jobs. Uh, I mean hand strength."


This led to a brief delay while the online panel composed themselves.

Reflections

Drug company advertising is, well, advertising. They're trying to get me to prescribe something.

I see drug ads all the time as I flip through journals. I ignore them. Most are meaningless collections of graphics, charts, and small print. But occasionally one will catch my eye.

A few years back Novartis ran a campaign for their Alzheimer's medication. Normally I'd have ignored it and turned the page, but the pictures were powerful and I stopped.

They've since moved on to more typical campaigns, but this one shouldn't be forgotten, so I'm going to share it here today.

Think of how you treat the elderly. Because someday it will be you on the other side of the mirror. Your newborns and toddlers and teenagers will be there someday, too. And the fragile old man/woman in front of you today was once you.

Overheard in the ER

Nurse: "I thought you were leaving AMA?"

Ms. Eword: "I am. You people here don't treat me right. I'm suffering, and in horrible pain, and you won't give me any Dilaudid. I'm never coming back to this dump."

Nurse: "So... why are you still here?"

Ms. Eword: "I want to finish my coffee."