Helpful

Seen on an office intake form.

House hunting

Mr. Patient and his wife come in. She's staring intently at something on her phone.

Dr. Grumpy: "Hi, folks. Have a seat.  How you been doing, sir?"

Mr. Patient: "Better, that medicine has really helped a lot and..."

Mrs. Patient "Mike, what do you think of the kitchen?" (shows him phone)

Mr. Patient: "Looks fine to me."

Mrs. Patient "I think it's too small."

Voice from phone: "Ma, you'll get used to it. You guys go out for dinner every night, anyway."

Dr. Grumpy: "Um, what's going on?"

Mrs. Patient: "We're thinking of moving to San Diego, and our son is showing us places he's looking at for us on Facetime."

Dr. Grumpy: "So about the new medication, have you had any side effects?"

Mr. Patient: "No, actually I've been... Steven, is that the garage? I need more space than that for my woodworking stuff."

Mrs. Patient: "It's not like you ever use it. I was going to donate it to charity rather than drag it cross country."

Mr. Patient: "The hell you will! I use it more than you use the kitchen."

Voice from phone: "Dad, be reasonable."

Mrs. Patient: "Your father is never reasonable. Haven't you learned that? Mike, answer the doctor's question."

Mr. Patient: "I forgot what it was."

Dr. Grumpy: "Any side effects?"

Mr. Patient: "No. Steven, is there a community pool?"

Spring break

My kids are off from school this week, so heading west to visit family and avoid snow.

In the interim, I leave you this thought.

When all we see in the news is the capacity of the human brain at it's worst (insane politicians, terrorists, and people with machine guns massacring school kids), it's easy to forget that same brain is also capable of things that are good, innovative, and entertaining.

Here's the Brazilian comedy team Barbixas. No knowledge of Portuguese is required.

Breaking news!

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


DATELINE: MINNESOTA

A teenage girl failed her driving test in spectacular fashion this week.

Photo: Buffalo, MN Police Department.

At the beginning of her driver's license behind-the-wheel exam, she put the test car into drive instead of reverse, jumping onto the sidewalk and plowing through the front of the building.

The same building where the office to take the driving exam was located.

No one, fortunately, was seriously injured.



DATELINE: DELAWARE

Christopher McDowell walked into the local police headquarters and asked if someone could give him a ride home.

Police officers quickly noticed that Mr. McDowell was:

1. Drunk (at least he wasn't driving, though. Good boy!)
2. The guy who was wanted for shoplifting and fraudulent returns at Kohl's.

He was taken into custody, charged with shoplifting, and released on bond.

Afterwards he was allowed to call for a ride home, and contacted his friend April Wright.

When she arrived to pick him up, police noticed Ms. Wright was the other person wanted for the same shoplifting crime at Kohl's.

She was then also arrested, charged with shoplifting, and released on bond.

The article doesn't say if she got to drive them both home afterwards.



DATELINE: COLORADO

Visitors to The Dinosaur Experience got more than their money's worth when the attraction's animatronic Tyrannosaurus Rex suddenly burst into flames.

Photo: Royal Gorge Dinosaur Experience.

 
When the fire, caused by an electrical short, started it appeared Mr. Rex had suddenly become Godzilla and was breathing fire. It quickly became apparent that something more was afoot.

The blaze was safely contained, and no one was injured. The owners report that a new Tyrannosaurus should be ready by summer.




DATELINE: FLORIDA

Two men were arrested following the burglary of a home. They tried to cover up the crime by burning down the house with Ragu-brand tomato sauce.

The owner of the home received a text that his alarm had gone off while he was at work, and called police.

Officers arrested the two men at the scene. They'd left a pot of the pasta sauce on the stove with a washcloth, hoping to burn down the house and make it look like an accidental fire.

Besides stolen items, the men also had an empty jar of Ragu in their car.

For unknown reasons, one of the suspects was wearing a bull-costume onesie when arrested.

Wednesday re-runs

Lunch today was from a new drug rep, pushing a sleeping pill.

She made the MAJOR mistake of rudely talking down to the office staff, letting them know they are peons, and that she only deals with doctors. This pisses me off, and even worse, it pisses them off.

Anyway, her sleeping pill's claim to fame is that patients who take it get an average of 7.8 hours of sleep. As a result, they have little pamphlets with this fact, and the rep had a big button on her jacket that said "Are your patients getting 7.8 hours every night?"

During lunch she left her jacket over the back of a chair outside our break room. While she was talking I noticed 2 of the office ladies disappear for a few minutes.

When Ms. Drugrep was leaving she put her jacket back on, and brought me an iPad to sign for samples. As I scribbled I noticed that the button on her jacket had been altered, and now said "Are your patients getting 7.8 inches every night?"

She has no clue, either. And I'll probably never find out what happens.

Annie's desk

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

Mr. Car: "Hi, I see Dr. Grumpy, and I just got a letter from the MVD that they're going to revoke my driver's license unless my neurologist fills out a form."

Annie: "Okay, why don't you make an appointment and bring it in. Let me transfer you to Mary... You know, it looks like you were last here about 7 years ago, and sent us a letter to release your records to a doctor across the country?"

Mr. Car: "Yeah, I moved here 7 years ago."

Annie: "So are you back now?"

Mr. Car: "No, I still live here in Faraway state. It's their MVD that sent me this form."

Annie: "Well, Dr. Grumpy can't fill out forms on someone he hasn't seen in 7 years. For that matter, I'm not even sure if he can do them for a state he doesn't have a medical license in. Did you ever see a neurologist there?"

Mr. Car: "Of course. But the copay to see him is $40, and I haven't seen him in about a year, and he wanted me to come in to get it done and get my refills and all, so I thought Dr. Grumpy would do it for free."

Annie: "No, he'd have to see you in person after this much time, and if you're on the other side of the country you'd be better off..."

Mr. Car: "But I don't want to pay the $40 for some bullshit paperwork! Can't Dr. Grumpy call my doctor here and ask him to waive the copay?"

Annie: "No, he's not going to do that. Unless you're going to come back and see Dr. Grumpy, this is between you and your neurologist there."

Mr. Car: "Can you call around Faraway and see if you can find someone who'll see me for free? I really don't have time to waste on this."

Artisinal mailbag

All right, here's some more artisanal bullshit you guys have sent in.


If you feed your cow artisanal grass, what comes out the other end?

Very few chains are as ubiquitous and generic in America as Walgreen's, and yet they apparently carry artisanal stuff. Which I'm pretty sure was "handmade" by a machine in southeast Asia.

"How stylish can you get?"

Making toast is right up there with boiling water and putting chips in a bowl as far as culinary skills go, but apparently you can now take your "putting bread in a toaster and pushing down in the handle" skills to a whole new level for only $24.95 with...

Even videogames are now into it:

At this point I'm ready for a drink

Butt you just knew someone would sell this:

Order it with the toast book and make Scotch Woodcock!

Shopping

I have a pretty good rapport with my patients, tossing jokes and mild insults back and forth during a visit. It's just part of the way I practice. Most of them like it, since it flies both ways. Patients that don't gravitate elsewhere.

But sometimes it has its consequences.

One of them, Ted, is an older fellow who works weekends at Costco, running sample stations. When he shows up they tell him where he'll be working that day. He briefly reads up on the product and sets up a table.

Yesterday, as I picked up some items to feed the teenage horde, I saw him at a table over by the pharmacy and waved.

He yelled "HEY, DOC! I'M SAMPLING ADULT DIAPERS TODAY! GOTTA LEAKY BLADDER? COME ON OVER HERE AND TAKE ONE!"

And he waved a free sample in the air at me.

My kids (and everyone else nearby) cracked up.

I yelled back "Ted, you're a dead man!"

Breaking news!

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

DATELINE: ARIZONA

A man and woman fleeing police officers attempted to escape by climbing a fence into a parking lot.

Unfortunately for them, the lot they chose was the secure one for the local police station, where several officers were conducting a training exercise.

Video surveillance shows the subjects somehow missing a large sign on the fence that said "POLICE DEPARTMENT."

Both were taken into custody.



DATELINE: TEXAS

From the "Bitcoin is so 2017" files...

In a sticky situation involving political donations, a local candidate has received several donations in... deer semen.

Yeah, you read that right. Frozen straws of deer jizz are worth big bucks, and are being sold and auctioned off at fundraisers. How you might explain coming home with frozen deer cum, as opposed to a cap with a political slogan on it, to your spouse is beyond me.

An attorney they interviewed for the story is named, I swear, Buck Wood.

Regrettably, the recipient of the donations isn't named Jane Doe, or even Bambi.




And here are some other interesting things seen in the news recently:

From the "who wrote the headline?" department:

Next, from the "I failed zoology" office:

And finally, we can only say, "I bet he did."

Mary's desk

Mary: "Hi, can I help you?"

Mrs. Lost: "Hi, I have an appointment with Dr. Grumpy, but I think I'm in the wrong suite."

Mary: "No, you're in the right place. Let me get you some forms..."

Mrs. Lost: "But Dr. Grumpy is in suite 608."

Mary: "This is suite 608. You found us! So if you can fill out..."

Mrs. Lost: "This isn't suite 608. It's 407."

Mary: "No, it's 608. You can see it on the door there."

Mrs. Lost: "When did you move to 407?"

Mary: "We didn't. Can I get a copy of your insurance card?"

Mrs. Lost: "Coming to the doctor is so confusing."

Skool Nerse Time

This is Mrs. Grumpy

This past weekend I somehow got dragged into chaperoning a school band competition, which involved a long school bus ride each way. The heavy snow didn't help, slowing the drive down to about twice what was expected.

I kept asking the band director if we could give up and go back, but she just laughed and said "the show must go on." As I stared at passing snow drifts out the window I wanted to throw her in them and let her walk.

Anyway, due to the unusually long drive we made an unplanned stop on the way home so everyone could use a restroom and get something to eat. Fortunately, America is full of generic shopping malls with a wide variety of stores and fast food places. So all of you disappeared for 20 minutes, which was fine with me, as I got some peace and quiet until you returned for the last 2-3 hours of the drive.

You guys were pretty quiet for the last leg, no doubt because of the effects of cheeseburgers and fries hurriedly crammed down at McWhatever's. Because of the silence I began to doze off myself. The band director, wired on her 28th cup of coffee of the day, was on her iPad maniacally working on next weekend's competition.

It was actually pretty relaxing until the screaming began in the back of the bus, and rapidly spread. I thought perhaps Freddy Krueger had climbed in through a window and was attacking the clarinet section. The bus driver almost crashed as he hurriedly pulled off the road and we all frantically piled out into the snow, terrified of, well, whatever had happened to set you all shrieking hysterically.

After the bus had been abandoned we got a clearer idea of the emergency.

Apparently a few creative souls, whose names we don't know at this time, had wandered over to House O' Reptiles and bought a paper bag FULL of crickets meant to be used for feeding lizards, and released them in the back of the school bus. This resulted in the mass panic.

A kindly police officer pulled over to see what the problem was. When told he climbed on the bus himself to see, and then began laughing hysterically. Our driver channeled his best Samuel L. Jackson and yelled "I've had it with all these.... crickets on this... bus!" (not quite in Mr. Jackson's original creative words).

With the snow coming down, and temperatures below freezing, and being 2 hours from home... we didn't have many choices. We all got back on the bus.

Usually there are a few couples in the back of the bus trying to make out, and I'm supposed to keep an eye on you. I must say, having a large numbers of arthropods crawling all over certainly put the kibosh on your hormones during the ride back.

Fortunately, that was my last chaperone job of the year.

Craig and Marie have asked me to buy them each a can of Raid to take on the next road trip.

The district has charged the band boosters an extra $75 for fumigation services.

Seen in a chart

Alone

Over the course of a career you see a lot of patients. I'd guess, based on looking through my charts, roughly 30,000-40,000 to date.

Most, especially the ones from the very beginning, are long forgotten. Sometimes I'll request old hospital records on someone from a place where I did a rotation and am surprised to see a note from a younger version of myself. And I have no recollection of them at all.

But a handful never leave you. Some because you learned a lot from them. Others because of a shared interest you chatted with them about. And a few because they struck a chord that's never gone away.

I was at the tail end of my intern year, doing a mandatory ICU rotation, when they brought him in. I don't remember his name now, mainly because I never knew it then, either.

He was a homeless man, who'd fallen asleep in a trash dumpster. In the dark early morning no one saw him fall into the back of a garbage truck when the container was emptied. With the noise of the engine no one heard his screaming as he was mashed by the machinery. When the truck was emptied a few hours later sanitation employees called 911.

He was still alive - barely - when we got him. Massive blood loss and multi-system trauma. Broken bones, ruptured viscera, missing pieces of limbs. Teams of doctors paraded in & out of the room trying to save him. As an intern I was one of them, but on the periphery of the internal medicine group.

What was left of his clothes had no ID, and he was never conscious. Social workers tried to find family, a name, anything. They combed missing person databases and made endless phone calls all over the country. Nothing really to go on, not even a tattoo. Just a 50-ish white male. Police spoke to other homeless who lived in the area. A few remembered him, but none knew his name or anything about him.

For a week in the never-ending daylight of the ICU an army of doctors, nurses, RT's, lab techs, and others did their best to keep him alive. Although his prognosis was grim, we all thought that, sooner or later, the social workers would turn up a friend, or relative, or find some lead to them. He was, after all, somebody's son. Or brother. Or father. If there was someone out there who might be able to tell us what he'd want, or even who just wanted to say goodbye to him, we'd give them that chance.

But it never happened. Roughly a week after he came in the attending doctors felt there was no hope and nothing further to be done. The machines were turned off one by one and he died quickly. Someone on the trauma service signed a brief death note and reached for the next chart. The body was taken away to an unmarked grave. I couldn't find it today if I tried.

I'm sure somewhere out there is an argument about how much money was spent on his case, and how many vaccines or school lunches or police or teacher salaries it could have paid for. Given how many cases there probably are like his, and multiply by that number... I'm sure it's a lot of dollars. But, while it has some points, that debate didn't occur to me at the time, isn't why I still remember him, and I'll leave it to other blogs to discuss.

Regardless of the circumstances of his life - I admit I'd have ignored him on the street if he'd asked me for change the day before - he died alone. Did he have any living family? Do any of them wonder what happened to him, then or now? Were they sick of whatever issues he had again and again, and had long pushed him out of their minds? Did he have a good childhood or was he always on the streets? Did he serve his country? Was he hoping to die in the dumpster or just looking for a little more shelter than the sidewalk offered that night?

Alone.

25-30 years later I can still see him as they brought him to ICU, the different teams of doctors yelling orders. For a week I'd sometimes sit at the nurses station and stare at him, wondering. Did anyone else working on the case find themselves as bothered as I was? Maybe we just all covered it up, afraid that to admit he was anything but a badly injured homeless guy would be a sign of weakness. I may be the only person today who even remembers him at all.

Alone.

The case still keeps me up at night. Thinking of him, and behind that the abject terror of the thought of someday myself, or my wife, or kids, or other loved ones or friends, being in the same situation. Alone. Impoverished with nothing. Unloved. A life and existence forgotten.

Alone.

Friday reruns

Saturday morning.


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

Miss Myelin: "Yeah, I see Dr. Cortex for my MS, and I woke up today with blurry vision, and I can barely walk."

Dr. Grumpy: "Have you had this before?"

Miss Myelin: "No, it's new. When my MS acts up Dr. Cortex usually admits me to the hospital for IV steroids."

Dr. Grumpy: "That's standard. I think you need to go to ER, and I'll likely admit you."

Miss Myelin: "Are you kidding? I don't have time for that shit."

Dr. Grumpy: "Excuse me?"

Miss Myelin "I don't have time for that. Can I schedule them for next week, like Wednesday or Thursday?"

Dr. Grumpy: "I suppose, but you'll have to call Dr. Cortex on Monday and... Look, if you're not going to let me help you, why did you even call on the weekend, anyway?"

Miss Myelin: "Because I thought it might need urgent treatment."