Bad! Bad technology!

Seen in a chart:

Thank you, JP!

Milestones

Due to her hypercompetitive nature, Marie beat both her brothers to be the first with a driver's license.

Since my wife and I need our cars for work, we decided to get one for the kids. We picked-out the closest street-legal thing there is to a tank: an ancient Toyota 4Runner with 290,000 miles on it.

"Marie, are you sure this is the way to school?"

Up until recently Mrs. Grumpy or I have always ridden with her, but now school has started. It was up to Marie to drive herself and the boys to school.

In other words, she was flying solo.

She made both boys sit in the back so they wouldn't distract her.

Of course, Mrs. Grumpy and I were still worried. We decided I'd follow behind them for a few minutes, to make sure everything went fine. Marie (and especially her brothers) were okay with this.

Off we went. Fortunately, Wingnut High School is only 3 miles away. Traffic was light. What could possibly go wrong?

About 2/3 of the way there, one of the boys texted me that the 4Runner was making a funny noise.

At the same time, I noticed smoke had begun pouring out from under its hood.

"Hey, do you mind if I smoke?"

Marie soldiered on. Not stopping, continuing to school. There was no way she couldn't have noticed there was something horribly wrong. Her brothers' texts to me became increasingly frantic that she wouldn't stop the car, wasn't going to pull over, AND HOLY FUCK DAD WE'RE GOING TO DIE!

Eventually, smoking away, she pulled into the school parking lot and found a space. Even with all this going on she carefully pulled in & out of it twice and stuck her head out to make sure she was right between the lines. She didn't seem to notice that everyone in the lot was either running away or taking pictures with their phone.

Except for her brothers, who'd bailed out at a stop sign 2 blocks earlier and were walking.

Then, leaving the engine running, she got out and calmly walked over to my car, signaling me to roll down the window. With remarkable aplomb she said "Dad, what do you do when the car is on fire? They didn't cover that in driving school."

I ran over and turned off the car (fortunately, nothing too horrible turned out to be wrong with it).

A security guard appeared out of nowhere with a fire extinguisher and began randomly spraying stuff.

The boys may need therapy.

Marie, upon being reassured that all would be fine, got her backpack, rolled her eyes at her brothers trudging down the road, and headed off to class.

Winter is coming

And with it, the annual Dr. Grumpy holiday gift guide!

As always, any of you who see something horribly tasteless, useless, bizarre, or otherwise notable, please feel free to send it to me for this year's edition. I can't guarantee I'll use every entry, but will appreciate all of them!

Words

Mrs. Semantics is a nice lady with carpal tunnel syndrome. She's trying to avoid surgery, so is wearing a pair of wrist braces.

Unfortunately, she doesn't call them braces, or splints, or supports.

She calls them cuffs.

Which leads to some entertaining quotes.


"You get odd looks wearing cuffs in public."

"I feel better when I wake up in cuffs."

"My husband put me in the cuffs last night."

Front line combat

Some random lady walks in.

Some random lady: "FINALLY!"

Mary: "Hi, can I help you?"

Some random lady: "CAN YOU HELP ME? Is that what you just said?"

Mary: "Uh, yes."

Some random lady: "I've been by your office 8 times in the last 2 weeks, and EVERY TIME the door has been locked. WHAT IS THAT SUPPOSED TO MEAN?!!!"

Mary: "Um, well, it means we're closed. We're open weekdays from 7:30 to 5..."

Some random lady: "Excuse me, did you just say it means you're closed?"

Mary: "Yes, we're open from..."

Some random lady: "THAT is completely unacceptable." 

(walks out, slams door)

Succinct

Today I'd like to feature a quote from a friend, that really struck me as spot-on.

He and I were talking about the shitty reviews people leave on rate-a-doc sites, and he said:


"You know, it's really too bad that people get their pre-conceptions of something as important as their medical care from places like Google and Yelp. It's like getting your wine selection from a drunk passed-out on MD-20/20 lying next to the railroad tracks."


Thank you, OC!

Random pictures

Okay, time to hit the mailbag for stuff you guys have sent in.


First there's this restaurant's hours:

Then there's this fairly generic news item, until you get to the end of the 3rd paragraph:

Here's a mouthwash label. Because nothing sounds better than saying it tastes "acceptable:" 

 When "supreme" isn't good enough for your urethra, there's always "supremium."

"Hey, how am I supposed to take this?"

 

Lastly, here's an advertisement for medical lubricant. For the life of me, I have no idea what they're trying to market with this image.

Patient quote of the day

"I know that they know that she knows, but what she doesn't know is that they know I know she knows. You know?"

Acronym FAIL

While the anti-synthetase syndrome is a serious disease, it really needs a better acronym. As this slide from an educational conference shows:

Thank you, E!

Guessing

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

Mr. Clueless: "Hi, this is Sid Clueless. I saw the doctor last month, and he ordered a bunch of tests. I had them all done several weeks ago, but nobody has called me with the results."

Annie: "I'm sorry about that, sir, let me check your chart."

Mr. Clueless: "It's ridiculous that you didn't try to reach me. I've been waiting all this time, and my wife and I are both really worried."

Annie: "I understand... Sir, I'm not finding you anywhere in our system. When did you see Dr. Grumpy?"

Mr. Clueless: "On July 27, 2017."

Annie: "You're not on the schedule for that day. Maybe you saw a different doctor?"

Mr. Clueless: "No, I definitely saw Dr. Grumpy. I know your building. It's the one with an elevator."

Annie: "Sir, that describes pretty much every medical building out there."

Mr. Clueless: "It's the one on Central and 74th Street, by the Sam Gross Cartoon Museum."

Annie: "We're all the way across town from there."

Mr. Clueless: "Oh... Maybe I didn't see Dr. Grumpy then. Can you still give me my results?"

Annie: "We don't have access to other doctor's charts."

Mr. Clueless: "I thought they were all in the computers you guys use."

Annie: "No, it doesn't work like that, sir."

Mr. Clueless: "Can you at least tell me which doctor I saw?"

Annie: "We don't know that, either."

Mr. Clueless: "Crap. Now I have to wait until my wife gets back from the store."

August 25, 1950

The U.S.S. Benevolence was a full-sized hospital at sea. She had 802 beds, many operating rooms, and the most up-to-date X-ray and lab equipment upon her completion in May, 1945.

She sailed to the Pacific, serving in the closing months of World War II. The casualties of the island-hopping strategy were terrible, and she took care of many as the allies closed in on the Japanese home islands.

At the Japanese surrender she was anchored in Tokyo bay, hidden behind the American and British battleships. Although hospitals don't get the glory that fighting ships do, they're still an indispensable part of any naval force.

After the big ships were gone, the Benevolence got down to work. 1,520 allied prisoners-of-war were released to her care, with her crew nursing them back to health so they could go home. She stayed in Japan until late November, 1945, doing this vital work.

The next month she sailed for San Francisco, bringing those too wounded to leave their beds back to the U.S. for further care. She spent early 1946 running back-and-forth between there and Pearl Harbor, transporting more injured home as they were brought in.

Later that year the atomic bomb testing was planned for Bikini atoll, and the Benevolence was selected to provide medical care for the operation. She served in this capacity through the entire project, and was then sent to provide hospital services in Tsingtau, China, anchoring there in October, 1946.

In 1947 she returned home and went into reserve, but was recommissioned and modernized in 1950 to serve in the Korean war.

On August 25, 1950, she was running sea trials off San Francisco before being sent overseas. She was 4 miles west of the Golden Gate Bridge, returning to harbor in a heavy fog.

A freighter, the S.S. Mary Luckenbach, was also blundering through the haze that afternoon, and just after 5:00 the two collided.

The Luckenbach was the less damaged, and anchored nearby to assess what had happened. Due to the fog her crew were initially unaware that the Benevolence was sinking rapidly, but as distress signals came in they manned their own lifeboats to go help. They saved 85 lives in the growing darkness.

The Benevolence was completely gone in just 15-20 minutes.

A makeshift rescue armada raced to the scene as night fell. Coast Guard ships, fishing boats, tugboats, pleasure craft, and merchant ships slowly moving through the murk, listening for voices, shining searchlights, and sending their own lifeboats back and forth to get swimmers. With the tide going out some survivors were miraculously found 12 miles west of the sinking, up to 6 hours later. One was floating on a wooden box of blood plasma.

As they returned to port almost every ambulance in the bay area was on the scene, taking them to hospitals and returning for more.

When it was all over 505 had survived and 23 were lost.

Both captains were faulted for excessive speed in the fog. The new radar technology on the Benevolence had somehow not seen the Luckenbach, and the Luckenbach's own set was malfunctioning and was turned off at the time.

When the sun came up and the fog cleared the next morning, the ocean off Golden Gate had an eerie sight: The 71 foot-wide Benevolence, lying on her side in 75 feet of water, with her red cross insignia clearly visible beneath the waves.

The navy surveyed the wreck for several months before deciding she was beyond salvage. She couldn't be left in the center of a busy shipping lane indefinitely, either.

In late 1951 the Benevolence was completely destroyed in a series of 3 controlled explosions to clear the area.

To this day she remains sadly forgotten, with no memorial to remember those lost that afternoon.

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: