Beware of the Dragon

Seen in a hospital chart:

Math

At a recent Continuing Medical Education course, the following slide was presented:

"And the rest become zombies."

Thank you, Diver Dan!

Rockin' down the highway

Dr. Grumpy: "At your last visit you were having migraines with orgasm, and so I started you on medication. Has it helped?"

Mr. Class: "I think so, I mean, I had my girlfriend suck me off on the drive here, and everything was okay."

Dr. Grumpy: (completely at a loss for words) "Um..."

Mr. Class: "Also, can you write a note to get me out of a traffic ticket?"

Things that make me grumpy

Recently, Marie's 8th grade girls basketball team won their division's state championship. It was the first time Wingnut School had ever won a state title of any sort. And what recognition did they get?

Zero. Zilch. Zip. Nada. Nothing.

Now, I'm not expecting a parade, or a call from the governor (generally only death row inmates want the latter). I mean, this is just 8th grade. But some acknowledgement outside the team (and us proud parents) would be nice.

In the morning announcements, where they routinely read off scores from boys sports (basketball, baseball, jacks, team scrabble) and upcoming chess club matches, were the girls winning the state tournament even mentioned? Nope.

When the boys basketball team vanquished their arch rival, Lockjaw Middle School 34-32, Wingnut put up a banner the next morning and had a pep rally over lunch. The girls beat Lockjaw 63-40, and weren't even mentioned in the announcements. Or school paper. Or PTA bulletin. Or pretty much anything.

The boys finished the season 8-6, their first non-losing season in 8 years (though didn't make the playoffs), and this fact was announced several times on the school's Twitter account, with pictures. The girls were undefeated at 14-0, and then swept the division's playoffs 6-0. The only time the school mentioned them on the Twitter account all year was before the season even started, to show them trying on their newly redesigned jerseys (which the parents paid for).

The sad part is that the people responsible for this sexist ignorance don't even realize what they're doing. It's 3 secretaries and a vice-principal who write up the morning announcements and plan events. The Principal herself doesn't want to be bothered with such trivial things.

I called and complained yesterday, and was told that a banner about the championship would be hung in the gym "sometime over the summer, when maintenance gets a chance." When school isn't in session.

Of course, they're not alone.

A few times each summer I take Marie and drive the few hours to see the nearest WNBA team play. I think the games are great. Personally, I'd say they're as exciting and competitive as the NBA, with a lot more teamwork and fewer ego conflicts. If you enjoy basketball, and haven't seen a WNBA game, I'd go.

But the same issues are there. The arena is maybe half-full, in spite of the quality of the play. Maybe Americans, by nature, just don't care about women's sports. For a country that often tries to pride itself on equality, women's basketball is far more popular elsewhere. The vast majority of WNBA players work year-round, playing here in the Summer and overseas the rest of the year to earn a living.

Not to mention salaries. In the NBA, pretty much the league minimum is $900,000 per year. And that goes to the guy who rides the bench all season.

In the WNBA? One of the league's biggest stars, Diana Taurasi, makes... $107,000 a year. While certainly not a small amount, Ms. Taurasi is actually taking the 2015 season off from her WNBA team to play in Russia for $1.5 million. And who can blame her?

It's sad to see that, at age 13, my daughter is already learning how much the accomplishments of a talented group of young women can mean. Which is, apparently, not much.

Mary's desk

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

Mrs. Urgent: "My daughter needs to get in to see Dr. Grumpy right away!"

Mary: "Okay. We have an opening on ..."

Mrs. Urgent: "It's an emergency. She needs to be seen urgently."

Mary: "Okay, we can see her tomorrow at..."

Mrs. Urgent: "No, she can only do a Friday, because of her school schedule.”

Mary: "Okay... Well, this Friday, at 3:15 she can..."

Mrs. Urgent: "No, that won't work. She works on Friday afternoons. The only time she can come in is on a Friday, before noon. But it's really urgent."

Mary: "All right, let me look... Our next Friday morning opening is in 2 weeks on..."

Mrs. Urgent: "Didn't you hear me earlier? This is urgent! She needs to get in right away!"

Mary: "Yes, and like I said, we do have an opening tomorrow at..."

Mrs. Urgent: "Obviously you're not listening, don't care, and aren't willing to help her."

Click

Catch-22

From a medication denial fax I received last week:

Define "valuable"

Invitation a reader recently received for a market research survey:

Thank you, Dr. M!

Things that make me grumpy

This is an actual note I had to dictate today.


Dear Dr. Intern,

Mrs. Payne returns today. I haven't seen her since March.

She says she never had any of the tests I ordered, and transferred care to another neurologist in North Grumpyville. She says she was unhappy with me and my staff, and didn't want to continue care here.

She continues to have a constant headache and intermittent arm tremors. She says the other neurologist is managing all these symptoms with medication, and has ordered further studies. I wasn’t previously aware of any of this.

The reason she comes in today is because she needs disability forms completed, but the other neurologist is on vacation for the next 2 weeks. Therefore she made this appointment with me to have them filled out since they're due before then. She's then planning to return to the other neurologist for future care.


Yes, Mrs. Payne, I did send that to your internist.

I'm sorry you felt it was unreasonable of me to refuse your request, but in good conscience I can't fill out forms on a patient I'm not treating. I'm sure some less ethical doc would have agreed to do so, and billed you $50 for it, but I won't even play that game. It just isn't worth it to me.

I didn't charge for your ludicrous visit, either. I probably could, but if it gets audited, or the insurance (or you) complain, I'm sure doing so would make me look bad. So I took a loss on the 30 minutes you'd booked "to discuss my case."

I'm not offended you don't like me. You learn early on in this job that you can't please everyone. But if you change docs, don't waste my time coming back here for bullshit reasons.

There simply aren't enough hours in my day as it is, and life is too short for that kind of crap.

Yours truly,

Ibee Grumpy, M.D.

Research

"In other words, do not try this at home."

Thank you, Webhill!

Can't hold it back anymore

Does your daughter love "Frozen"? Does she dream of being friends with Elsa? Has she ever told you that, when she grows up, she wants to be a neurosurgeon?


Well, now she can have it all!

Love the toenail polish

 

Yes, for the first time in forever, your little princess can be the attending neurosurgeon on call at Arendelle Regional (the area's only Trauma One center), when the queen presents with a hemiparesis after a skiing accident. She has an evolving epidural hematoma, and only YOU can save her!

Of course, neurosurgery isn't all brains (in fact, I've known a few neurosurgeons that may not have one at all). You could also be the pediatric spine specialist working when the royal family presents to discuss their young daughter's scoliosis.

I'm not making this up. Google it yourself.

Helluva pic, isn't it? Apparently someone forgot to call anesthesia before they started cutting. Also, if your surgery scars look like this, I'd probably find a surgeon who isn't in DT's during the procedure. Granted, some weekends that can be a challenge.

Oh, wait, now the anesthesiologist came in, so we can proceed. Who needs to intubate when you've got a binkie?

"A few Harrington rods and we'll have the spine frozen in place. Get it? Frozen?"

Of course, maybe brains and backs aren't your thing. Perhaps you prefer to work at the opposite end of the body. Well, there's a game for that, too:

"He does look a lot like Kristoff, Anna, but I swear it's just a coincidence."

Isn't that just wonderful? I mean, if you're sick of this shitty winter weather, here's your chance for payback with a big honking episiotomy. And with Elsa, you don't have to worry about warming the speculum. She's probably colder than it is, and it's not like the cold ever bothered her... Anyway.


Of course, the fun is only beginning with these skanky games. What else can give your little princess a healthy idea for a female role model than seeing a heavily-pregnant member of Arendelle's royalty doing housework?

"Hey, babe, can you get me a beer while you're up? Oh, and Sven shit in the hall, when you get a chance."

Apparently the pregnant midriff look is what's hot in Arendelle these days (probably the only thing that is). I'm pretty sure none of these sites are officially endorsed by Disney. And that one definitely isn't sanctioned by Kate, Duchess of Cambridge, either.


Of course, there's always the chance that Elsa will get sick of vacuuming and deck the cad (Prince Hans, I bet) who did this to her. One good punch and he's headed back to the Southern Isles. Let's just hope she doesn't hit him too hard or else...

"Hey! What the fuck is Dora doing in the picture?"

It may be expected that you kiss the Queen's hand when meeting her... But I'd have to decline. Looking at those sores, I don't know where it's been. For that matter, I don't want to know, either. Especially if it's reindeer Brucellosis.


No matter what happens, Elsa is likely going to need time to get back to normal. Which brings us too...

"Wait. Why the hell is there a paintbrush in here? Some horrible crafting accident?"

 And, I think it's about time to... let it go.
 

Thank you, Craig, for bringing these horrifying games to my attention.

Quote du jour

"My Dad suffered a fatal stroke when he was 68, but lived for another 15 years."

Annie's desk

Ms. Recite: "Major Illness Insurance medication review, may I help you?"

Annie: "Hi, I'm calling to get a seizure medication, Spykenwayv, covered for our patient Amy G'Dala for 2015."

Ms. Recite: "Certainly, let me look at her records... Has she failed the required generic medications?"

Annie: "Yes, same as last year when we went through this."

Ms. Recite: "Okay. I still have to ask, as some of our policies have changed for 2015. How long has she been on Spykenwayv?"

Annie: "Since 2010, same dose as last year.”

Ms. Recite: "And is it still working for her?"

Annie: "Yes. She's been seizure-free since she started it."

Ms. Recite: "Good. Now, for 2015 we have quantity limits of 30 pills per month on all of our tier 4 medications."

Annie: "But Spykenwayv can't be taken only once a day. It has to be twice a day because of its half-life. So she'll need 60 pills, technically 62, since most months are 31 days."

Ms. Recite: "Well, for 2015 Major Illness will only pay for 30 per month. That's the best we can do."

Annie: "Can I talk to..."

Ms. Recite: "Perhaps she could try taking it every other day? Maybe use a cheaper medication for the days between?"

Annie: "Uh, you can't do that with epilepsy medications. You have to maintain a stable blood level because..."

Ms. Recite: "Could she skip it on days when she isn't working? If she has a seizure at home would that be a big deal?"

Annie: "Yes. It would. She could have multiple seizures and end up in ER. She could die. She could injure her kids, or have a car accident."

Ms. Recite: "Since you mentioned ER, please remember that for 2015 Major Illness strongly recommends you go to one of our approved urgent care centers instead. They have convenient locations throughout the greater Grumpyville area and are staffed from 8:00 am to 6:00 pm weekdays and 9:00 am to 4:00 pm Saturdays by trained medically-affiliated professionals."

Annie: "I'd like to talk to a supervisor, please. This is an issue that seriously affects a person's life and well-being, and you're reading to me from a script."

Ms. Recite: "It may take a few days for her to get back to you. We only have one right now, and she's swamped. The other 2 both quit last week."

Workin' on a...

With spring coming and the snow finally receding, Mrs. Grumpy sent me out last night to buy gardening crap so she can try growing tomatoes at home (if this works, it could save us a fortune in tire wear and gas).

At the store I passed this sign:

Does it make anyone else think of the song "Sex Farm" by Spinal Tap?

"Gettin' out my pitchfork."

Neurologists telling neurology jokes

Jake is an elderly widower who lives at Shady Acres Care Home.

One day Sadie, who lives down the hall, comes over. "Jake," she says, "tomorrow the group bus is going over to see that new movie, and I'd like to go. But I haven't been to a movie since my husband died, and I'm nervous about going alone. Will you go as my date?"

Jake thinks for a moment. "You know, I haven't seen a movie since my wife died. I'd like to... But I have a request. Whenever we'd go to movies, I'd unzip, and my wife would hold my winkie during the film. Would you do that for me?"

Sadie thinks about it. "Why not? We're both in our 80's. What have I got to lose?" So they go to the theater, she holds his penis for the whole 90 minutes, and they both have a good time.

This goes on for the next several months, at every Wednesday movie outing.

Then, one day, Sadie calls to make sure they're on for that afternoon's trip, but Jake can't go. "I have a cold, Sadie. Sorry."

And the next time. "Sadie, I have a doctor's appointment."

And the next: "Oh, Sadie. I can't. I have to wash my hair."

"Jake, you don't have hair."

"I mean, the hair on my back."

This continues for another few weeks. Finally, Sadie confronts Jake outside the day room.

Sadie: "Jake, what's really going on? Why aren't you going to the movies with me anymore? No excuses."

Jake: "I... I've been going to them with Irma instead. I didn't know how to tell you without hurting your feelings."

Sadie: "IRMA? In room 507? Why? What does Irma have that I don't?"

Jake: "Parkinson's disease."