Monday, April 17, 2017

Mystery

Last week I got a letter from an insurance company about a patient's medication. No biggie. Happens a lot.

The letter said my patient's prescription authorization was expiring next month, and that I needed to fill out and resubmit the forms to get it covered for another year. Okay, I do that a lot, too.

But this letter, in the interest of protecting patient privacy, didn't give me their name. Or the medication. Or their diagnosis. Not even an ID number or birthday. Zilch. Zip. Nada.

In fact, across the top of the letter it said:


And I must admit they were right. The only name on the letter was my own.

So what am I supposed to do? I want to help the patient, but a quick look at my computer says I currently have 1,043 active patients. At least 278 of them are on a medication that requires me to re-authorize once a year. I can't start calling all of them, either. Ones who are coming due in the next 2 months? 44 per my machine. That's still too many for a random guess.

No easy answer here.

Sadly, the way these things usually play out is I'll only know who it is because they go for a refill and are told the medication is no longer covered because uncaring Dr. Grumpy never bothered to do the authorization. So they call and yell at me because they're not going to get their medication "AND IT'S ALL YOUR FAULT!" (my kids love that line, too).

I'm a big believer in patient privacy. I work hard to protect it. But when information about a patient, and a potentially life-saving medication for them, is kept secret from the very doctor who's prescribing it... We've reached a new level of insanity.


Franz Kafka (not my patient)

Friday, April 14, 2017

Supercalifragilisticexpialidocious!

Seen in a chart:




Of course, there's only one medicine that treats it all.

Wednesday, April 12, 2017

Memories...

One night, just after starting my internship, I got called to pronounce a patient dead.

How hard can that be?

They paged me just after midnight. As I took the elevator to that floor I realized that... I had no idea how to pronounce someone dead.
 
OH, SHIT!

My medical school had covered all kinds of stuff about diagnosis and treatment of the living, and, in retrospect, zilch about how to tell if someone is dead.

My stomach sank as I realized I'd be learning on the fly. I buttoned my brand-new white coat and made sure I had my stethoscope.

I got to the room. Mercifully, the family had gone home for the night and there were just 2 nurses straightening things up.

The ex-patient's eyes were wide open. He stared straight ahead, pining for the fjords.

Trying to look like I knew what I was doing, I strode confidently over to the bed... then stopped as I realized I had no idea where to start.






Finally, I waved my hand in front of his eyes.

He didn't blink.

The nurses began laughing. I began sweating.

Realizing I was hopelessly lost, and blanking, one took pity on me and suggested checking his pulse and perhaps use my stethoscope. At that point I began remembering things like vital signs (or the absence thereof) and other basic proof/disproof of life.



"He's dead, um, what's your name?"


I lay in my call room the rest of the night, waiting for a page from the morgue that the guy had woken up and was wondering what kind of idiot had pronounced him dead.

Monday, April 10, 2017

Sunday morning, 12:37 a.m.

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

Mr. Phone: "Yeah, I see Dr. Nerve for my headaches, and when I had one last month he called in some Migroblast, and it was really effective. Do you know if he'll call it in next time I have a headache?"

Dr. Grumpy: "Are you having a headache, sir?"

Mr. Phone: "No, I'm fine, I haven't had one since then. I only get a few each year. But if I have one, will he call in the Migroblast again?"

Dr. Grumpy: "Why don't you call his office on Monday and ask?"

Mr. Phone: "Oh, I guess I can do that. Hey, have a good night!"

Friday, April 7, 2017

Genetics

Mrs. Worry: "I'm concerned about Alzheimer's Disease, because I have a family history of it."

Dr. Grumpy: "Who had it?"

Mrs. Worry: "My ex-husband."

Wednesday, April 5, 2017

Mary's desk

Mr. Stand: "Hello?"

Mary: "Hi, this is Mary at..."

Mr. Stand: "Um, are you the girl I met last Saturday at Pick-Up Charlie's? Hey, the reason I haven't called yet is because..."

Mary: "Uh, no, I work at Dr. Grumpy's."

Mr. Stand: "I don't remember a bar called Dr. Grumpy's. Where is it? I must have been blitzed. Anyway, I'm glad you called because..."

Mary: "Dr. Grumpy is a neurologist. You have an appointment here at 10:00 tomorrow morning. I'm calling to remind you of that."

Mr. Stand: "Wait, you work at my neurologist's AND you came home with me from Pick-Up Charlie's last weekend?"

Mary: "No. I work here. I'm married. I've never been to Pick-Up Charlie's."

Mr. Stand: "Oh... This is awkward... I guess I'll see you tomorrow at 10:00, then."

Monday, April 3, 2017

100 years to the day

This picture was taken 100 years ago today, off New York City. It's the U.S.S. Arizona, shortly after completing engine repairs and only 6 months after she was commissioned into the navy. 3 days after this picture was taken the United States entered World War I.

At the time she was the biggest, newest, and most advanced battleship in the world. And home to 2,290 young men.




This is the same ship today, after the beginning of another war. 1,177 young men are still aboard her.


Friday, March 31, 2017

Check, please

This weekend Craig is hosting a murder-mystery party for his friends, with crimes he's writing himself.

Last night we stopped for a bite on the way home from band practice. He had a notebook, and was frantically writing down ideas for the party mysteries.

At one point he said "One more to go. I JUST NEED INSPIRATION FOR ONE MORE MURDER!!!"

Saying that loudly gets you some interesting looks in a crowded diner.

Wednesday, March 29, 2017

Publishing

Dear Cureus,

Thank you for your recent email.




I must say, I'm delighted that you enjoyed my article "," which was published in , . I spent years working on it, as a much-anticipated follow-up study to "?" and ".", which you may have seen in / and ;, respectively.

I'm impressed that your "new and unique" article rating system felt "," was so important. I'd been concerned, as several colleagues were less flattering, comparing it to something one might see produced by a :

Please keep an eye out for my "!" which will be featured in next month's issue of " as the centerfold.

Yours truly,

Ibee Grumpy, M.D.






- Thank you, SMOD!

Monday, March 27, 2017

Osteichthyes

Mrs. Gourami: "What's your fish's name?"

Dr. Grumpy: "Ed."

Mrs. Gourami: "And he just stays over there?"

Dr. Grumpy: "Yep."

Mrs. Gourami: "That really bothers me. I mean, for him to be in there all the time. You'd think he'd want you to take him out of the water for a walk or something."

Dr. Grumpy: "Uh..."

Mrs. Gourami: "It just doesn't seem fair to me, like animal cruelty."

Sunday, March 19, 2017

On the road again

Taking a week off for the kids Spring Break. See you next week!

Friday, March 17, 2017

"Don't eat or drink out of it, either."

Seen in a hospital bathroom:




Thank you, Rachel!

Wednesday, March 15, 2017

Parenting

Last night was the twins' indoor marching band show, combined with a school dance recital.

We took my Grumpymobile (a used 2007 Toyota Highlander, recently bought to replace the 1999 Nissan Maxima which had died). Frank also went, since he does lighting for the auditorium.

After the show there were 3 girls and 2 boys chatting with the twins. I let them talk for a few minutes, but after a while I wanted to go home, and went over to break it up.

Apparently, they’d been waiting on ME. Without bothering to check with, say, ME OR MRS. GRUMPY, Craig had previously promised these kids rides home. Since their parents had been told they didn’t need to come get them, they’d made other plans. And it was too late, dark, and cold to walk.

So we were 10 people in a car that holds 5, max.

It ended up as 3 in front (one on my wife's lap), 4 crammed in the back seat, and 3 shoved in the hatchback cargo area in back. It was snowing. The windows were fogged from 10 sets of respirations. Off we went, with my phone giving us directions to their homes.

Marie is taking driving lessons, and has memorized the entire book of state driving laws. So she points out any traffic violations she sees, loudly.

When someone made a turn in front of us without using their signal, she rolled down her window (with snow coming in) and shouted “HEY! That’s against the law!”

Craig's yelled from the cargo area: “So is driving around with 3 kids in your trunk!”

Then Frank farted, LOUDLY, and the whole car smelled like a sewer. On top of the body odor of a bunch of teenagers who have just finished marching and dancing for 2 hours under hot stage lights.

I drove the rest of the way with the windows down, and didn’t care if they froze.

At least I know these kids will never ask for a ride with the Grumpys again.

Monday, March 13, 2017

Guessing games

This referral came over the fax machine last week:



 
Locations of visitors to this page