Words

 

“Train wreck,” for the uninitiated, is medical slang for a patient with EVERYTHING wrong.

Example: “Mr. Smith in the ICU, room 17, is a train wreck. He has metastatic cancer and advanced renal disease. He was getting dialysis yesterday when he suffered a heart attack and then went into respiratory failure. He’s on a ventilator now, and has developed sepsis.”

Anyway

One day back in residency we were doing our usual morning rounds, presenting cases to the attending. My friend Zack was telling him about a guy he'd admitted the previous night.

Zack: “Okay, the next one, in ICU room 7, is a train wreck. He…”

Dr. Proper: “NEVER SAY THINGS LIKE THAT! Patients are people, and I don’t want to hear slang! Present the case to me in medical terms."

Zack: “I'm sorry, but I mean…"

Dr. Proper: “STOP! Let’s try this again. Why is the man in room 7 in the hospital?”

Zack: “Um, he was driving his car and was hit by a train."

Seen in a chart

As opposed to?

That's all the line said about it, folks. I didn't cut anything out.

My readers write

A 2nd year internal medicine resident sent this in:

I was doing night admissions, and one was an elderly lady who'd come in for a hip fracture. The ER doctor told me the ortho surgery resident had already seen her, but there was nothing in the chart to tell me what the plans were.

So I called the ortho resident to touch base.

Dr. Dudebro: "Ortho, returning a page."

Me: "Hey, I'm the medicine resident admitting Mrs. Hip. You evaluated her in ER a few minutes ago?"

Dr. Dudebro: "Oh yeah, with a broken hip! What's up?"

Me: "What's the plan for her?"

Dr. Dudebro: "Uh...she needs surgery."

Me: "Right, but what's your plan? When are you planning to take her?"

Dr. Dudebro: "Uh...I don't know. She needs surgery."

Me: "Okay, but she's on Coumadin and is therapeutic. Are you taking her to OR tonight, and I need to reverse her ASAP? Or is this less urgent, and I can just give her vitamin K and manage her pain until you're ready for her?"

Dr. Dudebro: "Uh...she needs surgery."

Me: "Never mind. I'll figure it out."

- Thank you, R!


And for those of you who remember:

Summer fun

I'm at work.

Mrs. Grumpy is out of town with the twins.

Frank is at home alone. He's 17, so should be able to survive for a few hours on his own, right?

Then, while I'm with a patient, this text from him shows up:

Breaking news!

From around the world, Dr. Grumpy's reporters bring you the stories that shape our lives.


DATELINE: Durango.

A bear broke into a parked Suburu SUV and took it for an early-morning spin.

The unidentified ursid, who's still on the loose, smashed a window and climbed in. From there it released the parking brake and went rolling down the street.

During its brief ride the bear drove over some utility boxes before finally going into a yard and hitting a mailbox. The homeowner, Mr. Ron Cornelius, was woken by the noise and called police. When asked about the early hour, Mr. Cornelius said "Usually, I don’t get up at 5 o’clock unless there is a bear driving a car down the street."

Apparently unhappy about its short ride, the bear destroyed the interior of the vehicle. It pulled the steering wheel off the shaft, ripped the radio out, and broke the back window.

Originally it was thought to have been the work of human vandals, but the bear's involvement was confirmed by the extensive degree of damage wrought and, more importantly, a large pile of bear shit that had been left inside the car.

So there you have it: Bears do shit in the woods, but in a pinch will use a Subaru.



DATELINE: Olympia.

A traffic jam was caused by a dead body rolling down the street.

Police said an ambulance transporting a dead body had its back door open while moving. Two gurneys, one with a recently deceased occupant, fell out and went speeding down the street.

The driver, unaware of this turn of events, continued on his way.

The gurney with a body stopped in an intersection, forcing police to re-route traffic through the area until coroner's staff could arrive to take the escapee into custody.

The empty gurney was found in a parking lot.

Neither gurney, nor the deceased, was damaged during the joyride.




DATELINE: Sioux City.

Police were called when a man attempted to deposit a fake $1 million dollar bill into his bank account.

Upon arriving to the bank, police officers interviewing the fellow asked if he had any more of the million dollar bills on him, whereupon he pulled a bag of methamphetamine out of his pocket.

Somewhat comically, he's being held on a $1,000 bond.

Police suspect drugs were involved.

"It's for the neurologist. You know how he can be."

A nurse writes that, when she arrived to work yesterday, this was the state of the galley fridge at her ICU:

Thank you, J!

Annie's desk

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

Lisa: "Hi, this, is Lisa, referral person for Deathtrap HMO."

Annie: "Hello."

Lisa: "Dr. Grumpy referred Mr. Axon to Dr. Needlemeister for an EMG? I thought Dr. Grumpy does these himself."

Annie: "He does, but Mr. Axon has a number of issues that make the test more complicated. So Dr. Grumpy prefers that an EMG specialist do it in this case."

Lisa: "Okay, but if Dr. Grumpy has another doctor do it, I want to make it clear that we will not pay Dr. Grumpy for the test. We'll pay that doctor instead."

Annie: "Of course. We wouldn't expect you to pay us for it."

Lisa: "You people are so weird."

Covering all the bases

Seen in a chart:

Thank you, C!

Summertime

It's Saturday afternoon. As I'm heading home from the hospital, Mrs. Grumpy texts me to get some tomatoes at the grocers and to pick up my Sarcasma at the pharmacy before she has to kill me.

I'd been at Marie's basketball game when the hospital called, and so was wearing an old Motörhead T-shirt. While waiting in line at the grocery store some guy came over.

Some Guy: "Hey, I like that T-shirt."

Dr. Grumpy: "Uh, thank you."

I'm generally not one for small talk, so stared at my iPhone and began checking email. Unfortunately, this didn't stop him.

Some Guy: "I'm a big Motörhead fan. I saw them in person back in the day."

Dr. Grumpy: "Cool."

Some Guy: "I love their stuff. I was busted up when Lemmy died. You know, I don't think I've ever seen that particular T-shirt. Where'd you get it?"

Dr. Grumpy: "Uh, don't remember." (Actually, I'm pretty sure I got it at the charity thrift store for $1)

(I texted Mary asking her to call me so I can answer my phone)

Some Guy: "How much do you want for it?"

(He didn't really say that, did he? I'll just keep staring at my phone.)

Some Guy: "I like it. How much do you want for it?"

(For a fleeting second I think about it. I paid $1 for it... Ask him for $40 and see what he says.)

Dr. Grumpy: "No, thank you. Then I'd have nothing to wear home, and I still have errands to run."

Some Guy: "That's easy. I'll give you mine."

I look at him. He's wearing a white wife-beater undershirt with food stains and probably more antibiotic-resistant organisms than an uncleaned colonoscopy tube.

Dr. Grumpy: "Uh, no thanks."

(Mary texts me back, asking how much a call is worth to me)

Some Guy: "Your loss, dude."

He walks off. I got the tomatoes and headed over to the pharmacy. While in line there...

Some Guy: "Hey! It's you again. Did you change your mind? I came by to get some condoms. I'm still willing to switch shirts."

Dr. Grumpy: "No, thank you. I'll keep this one."

(The other people in line are looking at both of us like we're street performers)

Some Guy: "I've got a sort-of cleaner T-shirt in my car, I'll throw that one in, too."

Pharmacist: "Next in line, please."

It's my turn. Thank heavens.

Back next week!

We're still dragging kids around (and vice versa).

Off, again

Heading out for our big trip of the summer.

3 kids, lots of relatives, and our credit cards.

See you in a few weeks!

Memories...

Back in residency, I occasionally had to round with Dr. Levodopa on weekends.

Dr. Levodopa, in a field of pathological personalities, had more odd mannerisms than I could count. But his strangest was that he carried a cup of black coffee... in his white coat pocket.

Not a travel mug, or even a generic cup with a plastic lid on it. But an open styrofoam cup. He'd fill it about 3/4 to the top at the nurses station, take a few sips, shove it in one of the coat's lower pockets, and start rounds.

So he had a large collection of white coats, all with dark coffee stains running from the right front pocket to the hem. As he'd walk, or move, or cough, coffee would slosh out, running down his white coat, pant leg, and to the floor. He never seemed to notice.

He was, though,  clearly aware of it, because he'd change into a clean coat as soon as he got to his clinic.

Like in "The Hitchhiker's Guide to the Galaxy," the resident on rounds with him would carry around a large towel (we kept several old ones in the call room for this purpose) to keep the floor from being slippery and wet as Dr. Levodopa wandered to and fro. He was, as best we could tell, completely oblivious to our efforts. Or, more likely, just didn't care.

25 years later... and I still don't understand why he did this.

Not particularly helpful

Seen in a chart. Apparently, death is a diagnosis, and it has a 100% chance of running in families.

Breaking news

Dr. Grumpy's crack team of reporters, bringing you the stories that shape your world.



Dateline: Shanghai, China. A flight from Shanghai to Guangzhou was delayed for 5 hours when an 80 year-old woman threw a handful of coins into one of the plane's engines. She apparently did this to ensure good luck on the flight.

A team of airplane mechanics had to disassemble and inspect the Airbus's engine to make sure none of the turbines were damaged and to remove all coins.

The total value of the coins involved was roughly 20 U.S. pennies.




Dateline: Tulsa, Oklahoma. A dead body was found inside a Walmart bathroom. It had apparently been there for 3 days.

A security camera recorded the 29-year-old woman entering the bathroom on Friday. At some point over the weekend an employee couldn't get the bathroom door open, and hung up an "Out of Order" sign. A repair crew found the body on Monday.

Police captain Todd Enzbrenner commented "It’s not every day you find this sort of thing in a business."




Dateline: Allyn, Washington. A man found a dead roadkill raccoon on the road, and decided to use it as bait to catch crabs. Like most dead things, it smelled awful, so he tied a rope to it to drag it about 15 feet behind him as he walked home.

Two drivers pulled over and confronted him, believing he was dragging a dead dog down the street. One of them shot the raccoon-dragging guy in the leg and drove away. He is expected to recover (the guy, not the raccoon). Police are searching for suspects.

Sheriff's department Lt. Travis Adams told reporters "I've been doing this for 21-plus years, and I've never quite heard the 'raccoon being dragged down the road' story before, so it's a new one for all of us."




Dateline: Modesto, California. A 45 year man was arrested for starting a fire in a Walgreen's bathroom.

The man told police that he'd had "an accident," and soiled his underwear. He went into the bathroom to take them off and, for unclear reasons, felt the best way to do so was to light them on fire - while still in them.

This got the underwear off, and the man tossed them in the toilet to extinguish the blaze. While no damage was done to the store (or, amazingly, him), this set off the fire alarm and they had to evacuate the building.