Summer vacation, day 6

The ship's newsletter today had a note today asking passengers to “refrain from leaving the water running or balcony door open when not in the staterooms.” REALLY? There are people doing this? WHY? If we were in warmer climes I could understand the balcony thing... but here it’s in the 30’s-40’s.


There was a late-night video game party in the teen lounge last night. When Frank didn't show up for breakfast I went to the kids' room. He was out cold, surrounded by Marie's stuffed animals.

"Gag, corneals, and doll's eyes all work. But nothing to sternal rub."

Today we were in Juneau. Not being in any particular rush to get into town, we waited until after all the other passengers left, and crew went on shore leave. Walking down the dock we noticed Peter getting off the ship.


From a cruise-ship view, everywhere you stop is basically a dock next to a row of T-shirt and jewelry stores, and somewhere behind them is a city. This is a near-universal constant. Someday it will apply to colonies on Mars, too. And beyond.


On the dock there was also a memorial to the cruiser U.S.S. Juneau, lost at Guadalcanal during WWII. Out of her crew of 700, 600 went down with her. Of the remaining 100, only 10 of them survived until they were found 8 days later, the rest lost to the elements and sharks. Her casualty list included the 5 Sullivan brothers.

I'm amazed how many restaurants in these cities cater to the cruise crowd. I mean, you're dealing with people who have access to unlimited amounts of reasonably good food each day, covering pretty much anything that's commonly eaten from land, air, and sea. The places have seafood? So does the ship. Alcohol? Ditto. Burgers? Yep. Steaks? Of course.

There are even shore excursions where - get this - you pay $55 per person to be taken to an all-you-can-eat salmon bake. Considering that at any given moment salmon is available at the ship's buffet, cooked-to-order grill, and formal dining room... I just don't understand this. But I'm not exactly a partial crowd because I am the only person on Earth who doesn't like salmon. But still, the point remains.

Apparently it's a state law in Alaska that at least one gift store have a large fake animal in front to be used as a photo spot. So here's one from Juneau:
 

They have an interesting feature called stair-streets. These are not streets you can drive down, but rather stairs ascending on each side to reach houses there. They are, however, mapped and numbered as streets and have addresses on them. I imagine this makes being a postman here a rather vigorous job, and is also a serious incentive not to forget your car keys.

We walked around for a bit. Craig had decided that, besides water and oxygen, he needed a selfie-stick. Not having ever wanted one, I hadn't shopped for one before. I figured it would be simple:

1. Find a selfie-stick.

2. Buy it.

3. Leave store.

I wasn't even close. There are so many variations on the damn things it's insane. And then you get into "what color handle should I get?" IT'S A FUCKING STICK WITH A CLAMP ON THE END! But this is the kind of decision the American teenager can agonize about. Then, when they finally pick one out, it turns out that one isn't working and we have to start all over again.

Heading down the street you pass some interesting business names:

We went to take the Mount Roberts tram up to the top of the city. While boarding was finishing, who should I see getting on but... Mrs. Bitchy. She saw that there were maybe 7 teenagers in the car (none of whom was actually near her, or even looking at her) and told the engineer she'd wait for the next one. As she stepped back she noticed me, and gave me the bird.

Honestly, folks, this prune isn't one of my patients. I'd never even seen her before this trip.

It was actually a pretty impressive ride, with an amazing view of the city. Going up, all the ginormous cruise ships in the harbor shrink until they look like bath toys. Everyone in the tram was frantically snapping pictures. Frank tried to film it, but when he switched on his phone's camera it began playing "Amish Paradise" instead. The displays and trails at the top are impressive, too, and there's a performance by the local Alaska String Band.


Tonight at dinner the Limoncello family wasted no time in getting tipsy and belting out "Happy Retirement." Then our waiter, Michael, came over and introduced himself.

Michael? Huh?

We asked him what happened to Peter. He said Peter had quit that morning "because he had a nerve problem" and flown home. My mother, trying to be helpful, said "my son treats nerve problems." My wife whispered "I don't think that's the kind of nerve problem he's talking about."

Marie said: "Will you bring me Ranch dressing?" Michael answered: "You already have it." And pointed to a serving dish near her seat.

Marie has dreams of such things

Marie was delighted.

We've taken several cruises, but this is the first time we've ever driven a waiter over the edge.

Past adventures

If you're enjoying this year's Grumpy family vacation, please remember that previous year's stories of travel insanity can be found on my family vacation home page.

Family vacation, day 5

We spent the next couple days steaming north through fog and rain.

This ship, like all of these types, has a small shopping mall. One store is always for sundries you left at home (like overpriced band-aids, antacids, & nail clippers) and souvenir crap (hats, shirts, jackets, etc.) with the cruise line’s name on them. The other stores are inevitably jewelry, watches, perfume, and leather goods for people who have nothing better to do then spend a fortune on jewelry after they already paid similar to book the trip in the first place. I do not understand this.

One store had this ad in the ship's newsletter. The tagline can be interpreted... in many ways.

"It's not the size of your gold chain, it's how you use it."

This ship has several good bands. Perhaps the most interesting is 2 guys who sit in the main atrium and play violin and accordion. After a few days of Fisherman's Wharf you find yourself looking for a can to drop a few bucks in, then realize that this is included in the trip. I liked them, but my mom wasn't as impressed, and called them "The Screechy Twins."


There are 3 other groups in lounges and theaters, and a good piano player/singer in the martini bar. Music is pretty hard to escape from on a cruise, except in the corridors and your cabins. It's everywhere else. If you're not hearing live music, then they've got elevator music in the background. All over. You cannot escape. We are Muzak. Resistance is futile.


They had a backstage tour of the ship's main theater. I noticed this hanging on the costume rack:

Tonight Peter was again shocked. Marie bravely decided to try escargot... with, of course, Ranch dressing.

Then he went around the table. My family has always had a thing about sauces, preferring to have them on the side. Peter was not wired for this concept. After the 4th person in our party of 6 asked to have whatever sauce was included “on the side” he snapped.

Peter: “What is this with the sauces? Is there a problem with the sauces? Did you have a bad experience with our sauces on a previous cruise?”

My mom: “No, we’d just like to try the sauce first before putting it on the meat. That way, if we don’t like it, we don’t have to scrape it off.”

Peter: “Okay, I assure you...”

My wife spilled her water.

Frank’s phone began playing “Amish Paradise.”

(Craig raises his hand)

Peter: “Do you have a question?”

Craig: “I just like raising my hand.”

(Puts hand down).

Marie: “Instead of sauce, can I have Ranch dressing? A lot of it?”


The family next to us started passing around Limoncello and singing "Happy Anniversary."

Peter was pale and his lips were twitching. He mumbled something and went off to put our orders in.



Following dinner Craig and I went to hold some seats for tonight's show. After we got situated Mrs. Bitchy (who else) came over.

Mrs. Bitchy: "You'll have to move. I had my eye on these seats earlier."

Dr. Grumpy: "No one was sitting here, and they weren't marked."

Mrs. Bitchy: "I usually sit in this row on cruises."

Dr. Grumpy: "We're only taking up 6 out of 20 seats. You can sit on either side of us."

Mrs. Bitchy: "That isn't acceptable. I don't like being near teenagers."

Dr. Grumpy: (referencing the shipboard app) "It's a 1000 seat theater. I'm sure you'll find something."

Mrs. Bitchy gave me the bird and tottered off, looking like she was being waterboarded with lemon juice.


Walking past a pool later, I passed this existentialist sign:

Summer vacation, day 4

This morning we headed off to the pier, to catch our cruise ship. Rather than stopping at a restaurant for breakfast I just took the kids to a nearby drug store to grab stuff. Like, you know, hard-boiled eggs:

"Dad, they have weird eggs here."

We also passed this smokin' set of wheels. Because nothing screams "CHICK MAGNET" like a bright orange 80's Oldsmobile with a flared-up hood.

And... we met up with my Mom and headed down to the cruise terminal. You see some interesting license plates, hopefully not an indication of what's in the driver's coffee mug:

"92 bottles of wine on the wall, 92 bottles of wine..."

Standing at check-in, the TSA agent asked Frank for his passport. As he handed it to her his phone said "I show 3 post offices that process passports within 10 miles of here. Would you like directions?"

I also noted this item being checked: a box that, whatever was in it, the owner saw fit to completely mummify with duct tape. I hope they remembered air holes.

"Getting it open is half the fun."

We boarded the ship. It's been 5 years since my last cruise, but every time I board one of these behemoths I'm always amazed at their sheer size. The modern cruise ships dwarf even the biggest ones of yesteryear. At Long Beach you can see them parked next to the Queen Mary, making her look like a boat. And she was one of the biggest of her era (1930's), dwarfing the famous Titanic (1912).

Getting into an elevator as we explored, Frank and I had our first encounter of the trip with Mrs. Bitchy. This is an aging prune who apparently thinks she owns the ship. She was standing in an elevator, by herself, when Frank and I got in. She immediately pressed the “door open” button and asked us to leave because “I was here first, and I don’t like teenagers.” Hell, some days I don’t like them, either, but given how long you typically have to wait for an elevator on board... we weren’t leaving. Besides, it's not like Frank had even done anything. He was quietly texting a friend back home. She flipped me the bird and got off to get another elevator.

In a new twist since I last sailed, the ship now has an app (of sorts). It's really more of a local website. When you switch on your phone's browser, it takes you to the ship's daily schedule (though didn't include the teen club schedule, which would have been nice), and allows you to check menus, make reservations for dinner, and a few other things.

It also has a texting feature. You create an ID, and can then text your friends and family aboard. It only works for others on the ship, and (on paper) beats the usual method of bringing walkie-talkies. It's a good idea, since using regular texting at sea is unreliable (due to crappy signal strength) and costly (since it's roaming)...

Unfortunately, it's pretty fricking WORTHLESS in execution. Why? Because it's not designed to alert you when someone texts you. No chime, no beep, no nothing. I thought maybe I was missing something and went down to the help desk. Nope. That's the way it works. So, if you're trying to ask your wife where to meet for lunch, the only way she'll know is if she's spending every freaking moment of the trip staring at the phone's browser. Who thought this was a useful idea?

We went down to dinner.

The family next to us (about 12 people at one table) ordered 2 bottles of Limoncello as soon as they sat down and sang "Happy Birthday." They then opened the bottles, and began passing them around the table. Each person, including the kids, would take a swig and pass it to the next person. This went on until the bottles were empty. They asked the waiter to have 2 bottles of chilled Limoncello on the table each night.

And I thought our family traditions were different.

Our assigned waiter on the cruise was Peter. He seemed pleasant enough, but was obviously unprepared for our family.

Marie believes that Ranch dressing is THE key food group. Ever since she discovered it at roughly age 3, it’s been a central part of our household. Restaurants and family members that don’t routinely keep Ranch on hand will get chewed out by her, often before my wife and I can hush her up. She has it with everything except dessert.

So, of course, she asked Peter for some Ranch with her 1st course (I don’t remember what it was) and he was horrified. “Ranch does not go with that.” Eventually he brought it, though was clearly reluctant to be contributing to our bad parenting. This got even worse when she ordered it with her main course. Each time he brought out a small thimbleful of the stuff, and couldn’t grasp that, say, a bucket would have been more appropriate.

As he was processing this, my Mom spilled her water. The assistant waiter dove head first into the table to mop it up before it could spread too far. Peter ignored this and (I assume trying to educate her on food etiquette) asked "do you know what kind of foods ranch dressing normally goes with?" Before Marie could answer, Frank's phone said "I don't see any grocery stores that sell ranch dressing within 5 miles of you" (no shit, we're at sea). Not being used to having Siri argue answer him, Peter slunk off.

The evening closed with me, Mom, and Mrs. Grumpy playing trivia in the lounge. This is always interesting, as most people by this time of night have had a few drinks.

On day 1 they emphasize, repeatedly, that if you hear the alarm you should get your life jacket and go to the muster station. Then they have the evacuation drill. The muster station (you hear little kids wondering if there’s ketchup, too) is where, in the event of the ship sinking, you hang out while waiting to board a lifeboat. You also practice putting the jackets on.

So at trivia one of the first questions was “what do you do if you hear the alarm?” All the teams got it right except for the one next to us, who wrote “stop, drop, and roll.”

The guy running the game said “wrong emergency” and shook his head.

Summer vacation, day 3

Today we walked over to Ghirardelli Square. I had no idea how dangerous a city this was:
 

"This is not going to look good on a headstone."

We did the obligatory stop in the chocolate store there, where I noticed this:

"Serves 4?" Really? Who are they kidding? I mean, my twins could knock that off easy. For that matter,  I know plenty of people who could handle it as a solo project. $40 seems like a lot of money for an ice cream sundae, but San Francisco is nothing if not expensive. Even a trip to the famous Exploratorium is $150 for a family of 5.

In the store there was a lady walking around, handing out little sample squares of chocolate. The twins made several attempts to leave and come back in through different doors to see if they could get more than one, but she wasn't buying it. I'm pretty sure she's used to seeing this tactic many times a day. The fact that they were wearing matching "Thing 1" and "Thing 2" T-shirts didn't help, either.

After the chocolate place we took a cable car toward the center of the city. The highlight of it was the brakeman working on the back. At one stop a group of people seemed unsure as to whether this was the car they were supposed to ride, and he yelled "Heading downtown! Now or never if you want to get on!" They started to take a few steps, stopped, and looked at a map. He muttered "the hell with this," turned the brake, and yelled "too late! Catch the next one!" It reminded me of Mary handling the day's victims patients.

We passed a hardware store, with this sign advertising a brass nozzle:

After having lunch and wandering around for a while, we decided to head back to the wharf. We were relying on my wife’s map-reading skills (far better than mine) to figure out what connections to use. Mrs. Grumpy walked over to the nearest stop, checked her iPhone, and said “this is the line we take. It goes one block that way, then loops toward the wharf.”

So, when it came, we all trooped on board. The bus carried us down a block, then stopped, and the driver yelled “that’s it people, end of line, everybody off.”

So much for that idea.

Great.

Now what? As we climbed off, Mrs. Grumpy asked the driver which line to take back to the wharf. He pointed to a spot across the street and said “You want that bus stop over there. You’ll have to wait for the next one.”

So we crossed the street (which can be pretty hazardous in San Francisco) and sat down at the new place. Marie noticed a pile of dog shit on the curb and took a picture of it. Frank's phone began playing "Amish Paradise." Mrs. Grumpy and I idly watched as the rest of the passengers cleared off our previous bus across the street, and it drove off...

... And after about 50 feet made a U-turn, and came over to our stop. The same driver who'd just tossed us off re-opened the door and yelled “F Line, heading to the wharf, have your passes ready.” So we re-boarded, and were back in our previous seats less than 3 minutes after getting off the same bus.

I don't understand this.

In a line of people waiting for a cable car was this group of tourists:

Frank said "Dad, do you think they're all together?" Before I could think of a suitable response, Craig beat me with, "No, Frank, they're a bunch of prison escapees in orange waiting for their getaway bus."

Back toward the water, we wandered over to the wharf. We passed a bunch of guys hawking cheap tours on their boats around the harbor. One kept offering to let anyone who wanted to try to drive the boat around Alcatraz. Frank loved this idea, but since I can't afford to buy the guy a new boat we went on.

Fisherman's Wharf is a big tourist attraction, and as such brings out a large number of street performers. There's no shortage of guys covered in gold or silver body paint dancing to boom boxes, people dressed as celebrities to take pictures with, one guy in a cow suit wandering around on all fours and mooing (maybe he isn’t a performer), a teenager with an iPhone that randomly plays "Amish Paradise," street mimes, guys working as living statues, people playing a variety of instruments, and a whole host of other previously unknown talents. It's like a 78-ring circus. Or a mass episode of The Gong Show.

But THE star wharf performer is The Bush Man. This guy has been here for over 35 years, which is a pretty long time in any career, especially busking. His act is pretty simple: He carries around tree branches, hides behind them, and, when unsuspecting tourists wander by, jumps out screaming “OOGAH BOOGAH!” Then people pay him for this. Occasionally small kids will join his show to scare others.

He scared the crap out of my kids. That alone made it worth handing him a few bucks.

Of course, as is typical of such places, very little of Fisherman's Wharf has anything to do with the city's history as a major fishing center. What may have once been an interesting site is now mobbed with unrelated T-shirt and souvenir shops, Build-a-Bear and Build-a-Model-Car franchises, idiotic theme restaurants, ice cream places, coffee stands, and various other touristy stuff.

There was also this place, apparently decorated by someone unfamiliar with sports:

Another store had these signs for sale. I texted the pic to Mary, who said she wanted one of each for the office.

One guy we routinely saw cruising down the wharf was a fellow in a fairly old motorized scooter that, for unclear reasons, had a remarkably high-tech, LOUD, stereo system mounted on it. So as he headed down the sidewalk at 5 mph he was blasting music at more decibels than a Metallica concert. In fact, we never seemed to get away from him. No matter where we went, regardless of time of day, he was rolling along behind us.

Even the panhandlers have a sense of humor:

Walking through the hotel garage on the way back I noticed this parking job. I guess I never considered SUV's compact cars (unless compared to, say, a cement truck), but hey, I'm not a valet, either.

At dinner tonight the twins had one of their weird fights, this time about the kind of soap to use in the dishwasher. As usual, they turned to Siri to settle it (because, you know, parents don't know shit):

Summer vacation, day 2

Waking up this morning I was glancing through the news and noticed this story. I had no idea Elvis was a terrorist:
 

While waiting in the lobby for Craig to finish his hair, Marie and I watched a lady order 2 guys around as they wrestled a large-screen LCD TV up to her room. She was telling someone on her iPhone that “I hate the crappy TV’s in hotels these days.”

I do not understand this. But, as they say, whatever.
 
Today we took a bus tour of San Francisco.


This was given by our friendly, but hyper, tour guide Nicole. Apparently fluent in several languages, she often seemed to forget the nationality of her group that day, and would frequently switch into Italian, French, Spanish, or German at random intervals for a few sentences before returning to English. This made the monologue confusingly entertaining. She’d often refer to us as her “love children” and herself as “Mama Nicole.” So while trouping around you’d hear her say stuff like “My love children, follow Mama Nicole this way!” You'd think this would get you some weird looks, but in San Francisco they're used to such. You get the impression Nicole has been doing this forever.

We walked down Lombard street, which is clearly one of the worst places in the world to buy a house. Your street is constantly jammed with tourists driving down it bumper-to-bumper, tourists walking down the sidewalks and taking pictures of cars full of other tourists weaving slowly back and forth, and tourists randomly walking out into the middle of the street to take selfies of themselves with cars coming downhill behind them driven by other tourists. I have to wonder how many of those pics ended up being in their obituary when they get mowed down. Those who live here have to deal with pulling in & out of their driveway with this mess going on.

We stopped and briefly toured Grace Cathedral. This lovely building has a stained glass window celebrating one of my heroes, Albert Einstein.

 

There are also windows for John Glenn, Jane Addams, Robert Frost, and Thurgood Marshall.

Heading elsewhere, Mama Nicole had us go look at the city's famous row of Victorian houses.

She really outdid herself on this one. As we stood in a nearby park looking at them, she said "These are some of San Francisco's Victorian houses, and this group is called the Painted Ladies, also Postcard Row. This is because so many postcards of San Francisco feature this group of Victorian Houses, or Painted Ladies. As a result, they call it Postcard Row, because it features the Painted Ladies, which is this group of Victorian Houses." Then she switched to German.

The timing is great on this sort of tour. You frequently heard Mama Nicole say stuff like, "This is a lovely building, so many things to see, so be sure to explore it all and enjoy. It's 10:45 right now, so let's meet back at the bus at 10:47 so we can head to our next destination."

A teenage kid on the tour began complaining about not having had lunch yet starting at around 9:30 in the morning, and only kept getting louder about it. At 10:00 it was “unreasonable.” By 11:00 it was “unbelievable” that we hadn’t had lunch. 11:30 he was pleading with his parents to discontinue the tour so he wouldn’t starve to death. When we finally did stop in Sausalito for lunch he was apparently on his deathbed, until he began arguing with his parents about where they should stop for lunch. When they picked a place he didn't like, he refused to eat lunch.


We took a ferry back to San Francisco, then walked through the Market Building and passed this place:

Later on we toured the U.S.S. Pampanito, a WW2 submarine. If you've never been aboard a WW2 sub, it's definitely something to do. You walk through the cramped spaces and imagine spending more than 2 months at a time inside. Today's nuclear behemoths are luxurious in comparison, and they ain't that big, either.

To give you an idea, here's Marie, at 5'4", standing next to a hatch that, when on patrol, a bunch of big guys had to race through when the alarm sounded:

There was another ship at the pier, the S.S. Jeremiah O'Brien, but I'll talk more about her another time. She's a good story.

Tonight we met with numerous family members for dinner in Chinatown, where my kids where horrified by some of the things we passed hanging in grocery store windows.

If I have any regrets about San Francisco, it's being here 31 years too late for my kids to see the infamous waiter Edsel Ford Fong in action. I'd prefer that to the hyperpeppy types you get at TGI Fridays and such.

Summer vacation, Day 1

A few days before we left, Frank dropped his phone in the pool. So we stuck it in a bag of rice for 48 hours, with some improvement. Since we were heading out for our trip soon, we didn’t have time to take it in to the store.

Fortunately, it only had 2 issues. Unfortunately, they were:

1. A tendency for Siri to randomly answer questions she’d overheard, even though no one had asked her, the home button hadn't been pressed, and the "lift and talk" feature was off.

2. It would randomly play snippets of Weird Al’s song “Amish Paradise” for no obvious reason.


We started our trip in San Francisco this year. I haven't been there in many years, and my kids have never been there at all. So we figured we'd fly in and see the city and visit with family for a bit.


When I was younger the pictures on the flight attendant buttons were a generic female shape in a skirt. But with the profession now having a share of men in it, they've gone to this. Which to me looks like the international symbol for "I accidentally amputated my hand."

Landing in San Francisco you see signs that you don't see back in Grumpyville:

At first I thought it was odd, but then realized that if anything can prepare you for spending 4-5 hours twisted into a cramped, uncomfortable, position in an economy-class plane seat, it's yoga. Or an iron maiden. Or both.

There was also this:

Craig said "people are animals, so I'll pee over there." We stopped him.

We got to our hotel, which was within walking distance of Fisherman's Wharf. Yes, I know the Wharf is a huge tourist trap. But, we're tourists, so we're going to do that kind of crap.

One of my favorite attractions near the wharf is the Musée Mécanique. This is a remarkable collection of 19th and early 20th century mechanical amusement machines, the forerunners to pinball machines and (later) the videogames. You'd drop a coin into one, usually to see some sort of brief show by automated figures. Some had interactive features, such as boxing or hitting a ball. The place is free, but the gadgets require quarters. The entertainment value is awesome.

The most horrifying thing is located by the front entrance. It's an automaton called "Laffing Sal" which towers over you at over 2 meters high. It's a hideous mechanical woman who, when you put in a coin, cackles hysterically. It is not a good laugh. It is a watch-small-children-run-in-terror laugh.

What's really fun to see are the things that were considered amusements back then. People complain about video games today having sex, violence, drug use, and alcohol, right? Do they really believe this is a modern phenomenon? Let's look at some games from well over a century ago:

There was also this one, with instrument playing monkeys:

As we were leaving, Some little girl asked her mother if they could go get ice cream. Frank's phone immediately said "I show 14 ice cream stores within 2 miles of here."

She began screaming and hid behind her Mom. You'd have thought she'd put a quarter in Laffing Sal.



Heading back to our hotel for the night, the kids began yelling the air conditioner was broken and we'd freeze to death during the night. It wasn't, just Celsius.

"This is 'Murica, man."

And that's the way it is.

Your attention please

The chronicles of what happened during the Grumpy Family 2015 Summer Vacation will begin on Monday.

The 1983 model Wagon Queen Family Truckster

Partial-Onset Seizures

Wanted: New acronym.

Politics

John Oliver's take on what is currently the best sex scandal in America... is too good not to share.

The story is so bizarre, it proves what those of us in medicine already know: nothing we could make up is funnier than the truth. Ever.

Thank you, K!

Tuesday morning

Dr. Grumpy: "Any other questions?"

Ms. Calcium: "Yeah, why do drugs for Gkar-Londo Syndrome cost so much?"

Dr. Grumpy: "I don't know... honestly, that disorder isn't even in my field. I assume it's because of the  costs involved in research for a relatively uncommon disease, and bringing a drug to market, and..."

Ms. Calcium: "IT'S AN OUTRAGE! People need these drugs!"

Dr. Grumpy: "I'm sorry."

Ms. Calcium: "Sorry? Why aren't you doing anything about it?"

Dr. Grumpy: "Ma'am, I don't know anything about the disease, or its treatments, and I really have no say in what drug companies charge. I can't change..."

Ms. Calcium: "That's not good enough. You should be doing something."

Dr. Grumpy: "Such as...?"

Ms. Calcium: "I don't know. Writing letters to a TV station or congressman or hospital. Hand out pamphlets at the airport. You know, something like that."

Pop quiz

Okay, medical and pharmacy students. Get out your #2 pencils and tell me what's wrong with this medication list from an internist:

Thank you, Nell!

Hungry? Bow bow bow...

At Local Hospital, about 30 minutes before mealtime, someone from "Dietary Services" (previously known as the cafeteria) walks into a patient's room to take their order, entering it on an iPad.

Obviously, the staff hired to do this are not medical people. They're usually teenagers. Some are doing it as a job, others to get some background in hospitals for a college application, some are even volunteers doing it because their school requires community service.

Generally they're a fairly upbeat, happy, bunch. It probably beats flipping burgers and asking "do you want fries with that?" Hell, some days I wish I had that kind of enthusiasm for my job.

Anyway.

I was on call this past weekend, and yesterday morning saw a sweet old lady, who'd suffered a stroke the night before. Her language function was limited to saying "yes."

After examining her I sat down at the station to review her tests and dictate a note. The nurse came over and we talked about my orders.

As we chatted, one of the perky cafeteria staff went into the room and began her spiel.

Miss Chipper: "Hi, Mrs. Broca. I'm from dietary services. Would you like scrambled eggs for breakfast?"

Mrs. Broca: "Yes."

Miss Chipper: "We also have vegetable omelets today. You want one of those, too?"

Mrs. Broca: "Yes."

Miss Chipper: "Pancakes?"

Mrs. Broca: "Yes."

Miss Chipper: "My, you're hungry today!"

Mrs. Broca: "Yes."

Miss Chipper: "We have plain, chocolate chip, and blueberry pancakes. Any of those sound good?"

Mrs. Broca: "Yes."

Miss Chipper: "How about I bring you one of each?"

Mrs. Broca: "Yes."


The nurse and I were hysterical, leaning against the wall and each other, trying not to start cackling aloud. She bit her tongue. 


Miss Chipper: "We have turkey bacon and sausage."

Mrs. Broca: "Yes."

Miss Chipper: "I'll get you a little of each. Would you like coffee?"

Mrs. Broca: "Yes."


The nurse and I are envisioning this immense Las-Vegas-buffet sized cart being pushed up to the room.


Miss Chipper: "Now, for juice, we have apple, tomato, orange, and prune."

Mrs. Broca: "Yes."

Miss Chipper: "You like them all? Is one of each okay?"

Mrs. Broca: "Yes."

Miss Chipper: "Do you want sugar and creamer in your coffee?"


The nurse couldn't take it anymore. With tears running down her face from laughing, she called Miss Chipper out and explained the situation to her.

It was a while before I was able to dictate a note.

Thank you

He's also a doctor. Retired, but still relatively young.

He came to me for back pain, which sounded like fairly benign stuff. But when he worsened dramatically after 2 sessions of physical therapy, it was time to look further.

Unfortunately, the MRI showed a malignant tumor, leading to a bigger work-up. It was quickly obvious that he had widespread metastatic disease.

We put him in the hospital, and he went through chemotherapy, radiation, and back surgery. Fortunately his disease responded to treatment and he got better. His back pain improved and his leg strength returned. My job was done, now it was up to the oncologist. I signed off his case, wished him good luck, and told him to call me if any new neurological issues came up.

Time went by. His oncologist kept sending me copies of her notes, so I peripherally kept up to date. I'd scan them to see how he was doing, make sure there weren't any neurological issues I needed to deal with, and put them in his chart.

This went on for 2 years, when his notes showed he'd taken a turn for the worse. He had more difficulty breathing, and they found the cancer was back. Further chemotherapy and radiation weren't as effective, and he kept going downhill. I watched, sadly, as his weight and health declined in the increasingly frequent notes from the oncologist.

Then, yesterday, toward the end of the day, Mary handed me a piece of paper. He'd called, looking to speak to me, and asked that I call him at home. He said it wasn't urgent, so I stuffed it in my pocket and wrapped up the day. There were kids to pick up, homework to supervise, tomatoes to buy.

After dinner, when the evening had settled down into the usual quiet chaos, I went to my desk, brought his chart up on my laptop, and called.

Dr. Grumpy: "Hi, it's Ibee Grumpy. You were looking for me?"

Dr. Good: "Hey, thank you for calling me back. Haven't talked to you for a while. Have you been following my notes from Dr. Onco?"

Dr. Grumpy: "Yes."

Dr. Good: "Good, so you know what's going on. She's a damn good doctor, glad you sent me to her."

Dr. Grumpy: "Yes, how are you..."

Dr. Good: "Look, Ibee, I'll get to the point here. I've had enough of this shit, and it's time. I've decided to stop treatment, and signed up with hospice today."

Dr. Grumpy: "I'm sorry..."

Dr. Good: "Let me finish. Anyway, I know I haven't needed you since this all started, but I just wanted to call and say thank you for everything. I know you and everyone else did your best, and by catching it when you did you guys bought me an extra 2 years I wouldn't have had. You're a good doc, and I know you care. I think of all the patients that I saw, and I hope they feel the same way about me."

Dr. Grumpy: "Thank you, I..."

Dr. Good: "That's all. Thank you for everything, and good luck. Maybe we'll meet again out there."

He hung up.

He called to say "thank you."

I stared at the phone for a long time.