Thursday, November 22, 2018

Thanksgiving memory re-runs

One Thanksgiving in the early-90's I was the intern on call at a local VA hospital (a veterans hospital for my non-U.S. readers, with consequently a primarily cantankerous elderly male population).

A peculiar thing about VA hospitals (at least back then, I haven't worked at one for > 25 years) is that patients could sign out at the nurse's desk to leave, then come back later to resume medical care (don't even try to understand this). So the sheet was always full of notations that patients had signed out to go to McDonald's, or buy cigarettes, or smoke, or visit friends at the homeless shelter, or hold up a liquor store, or whatever.

Some bright businessman had opened a strip club across the street from the hospital, I think it was called The Jaguar Room. So on Thanksgiving the VA ward I was covering was empty, as most of the patients had signed out to walk, wheel, or crawl over to The Jaguar Room for some female comfort and booze.

I was asleep in the intern's room when the calls began coming in, all from the bartender at The Jaguar Room. Was it safe for my patients to be smoking through their tracheostomy tubes? Were the cardiac telemetry packs still transmitting from across the street? Was there a place at the VA where patients could get more $1 bills, because they'd used them all up on the strippers?

And my favorite:


Bartender: "Can I give Mr. Veteran another beer?"

Intern Grumpy: "Um, what's the problem?"

Bartender: "He has one of those foley bags things, with the tube going up his dick. The bag is, like, REALLY full, and I'm afraid if I give him another beer it'll pop and send piss everywhere."

Intern Grumpy: "Send him back to the hospital."

Bartender: "That's bad for business."

Intern Grumpy: "So is showering your clientele with piss."


Mr. Veteran was wheeled back over to the VA immediately, by a topless stripper no less, who waited while his bag was emptied and then pushed him back to the bar.

Monday, November 19, 2018

Ebay has everything

During her appointment I was helping Mrs. Old find a better price on her pain medicine, which (of course), activated the ad-tracker software.

So a few minutes later I noticed this on a site:



Thursday, November 15, 2018

Who are the people in your neighborhood?

Dr. Grumpy: "At your last visit... let me look at the note... okay, you said you wanted to see if a massage helped your back pain, and were going to try a place near your apartment. So how'd that work?"

Ms. Lumbago: "It, um, didn't happen."

Dr. Grumpy: "Too expensive?"

Ms. Lumbago: "No... I went in there one day, and said I needed a massage, and the girl at the counter gave me a blank look. Then I realized all the girls there were in skimpy bikinis, and they had candles and soft music and a bottle of champagne out, and the counter girl said, um, 'we only take men customers' and I realized that, um... anyway I left and haven't had time to look for another place."

Monday, November 12, 2018

Seen in a chart

Knowns and unknowns, both unknown and known.



- Thank you, C!

Thursday, November 8, 2018

Chutzpah

It's 10:55. Mrs. 11:30 walks into the waiting room, where Mr. 11:00 is reading a magazine.


Mary: "Hi, can I help you?"

Mrs. 11:30: "Yes, I have a routine appointment with Dr. Grumpy at 11:30, but my husband has a work-in with his cardiologist downstairs at 11:45, which he just made. Can I be seen early, so I can run down there?"

Mary: "I'm sorry, he's with someone now, and has an 11:00 appointment ahead of you. Otherwise I would."

Mrs: 11:30: "Can you..."

Mr. 11:00: "Hi, I don't mind waiting. I have the 11:00 appointment, so why don't you just switch us out? I don't have to be anywhere right away."

Mrs. 11:30: "Oh, thank you so much."

Mary: "Okay, that works for me. I'll let the doc know you're switching."


I finish with Mr. 10:30 and bring him up to check-out. Mary quickly explains the schedule change, so I bring Mrs. 11:30 back to my office. I address her issues, and we conclude the visit at around 11:25.


Dr. Grumpy: "All right, let me know how the medication change works out... I hope everything is okay with your husband."

Mrs. 11:30: "My husband? Why?"

Dr. Grumpy: "You said he had an urgent work-in with his cardiologist?"

Mrs. 11:30: "Oh, I just told the front people that. He's fine. I just needed to leave early because my cat sitter can't stay past 11:45."

She walked out front and left.

Monday, November 5, 2018

Texting with Frank



Also, stop calling me "Bro."

Thursday, November 1, 2018

Seen in a chart


For my non-medical readers, the last word is supposed to be "hematuria."

Monday, October 29, 2018

Annie's desk

Annie: "Dr. Grumpy's office. This is Annie."

Mrs. Daughter: "Hi, Dr. Grumpy saw my mother last week, for Alzheimer's disease. We're trying to get her long-term care approved, and need him to fill out the forms. I forget to ask him when we were there. Can I drop them by the office later today?"

Annie: "Certainly, but he's out of town this week, so won't be able to do them until he's back. We can mail or fax them back to you when ready, or you can come get them."

Mrs. Daughter: "What do you mean 'he's out of town?' "

Annie: "Family vacation stuff, his kids are off for fall break, so..."

Mrs. Daughter: "That's ridiculous. I want these forms done NOW."

Annie: "Well, he'll be back next week, so will be glad to do them then, or you can see if your mother's internist can..."

Mrs. Daughter: "The internist is the one who referred me to you. Obviously, I wouldn't have come to you if I'd known he was THAT kind of doctor!"

Annie: "Um, what kind of doctor?"

Mrs. Daughter "The kind who takes vacations when his patients need him!"

Monday, October 8, 2018

Time out

All right, gang. I'm going to have to take a few weeks off here. We're now entering the heart of the high school marching band competition season, and between my day job and band meetings, band fundraisers, band shows, band-aids, band trips, rubber bands, and band saws I need to take some time off from the blog (and a lot of other stuff, too).

See you in a few weeks!

Thursday, October 4, 2018

Breaking news!

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


DATELINE: SANTA MARTA, COLUMBIA.

Yeimy, a married woman, and Jesus, who she'd been having a clandestine year-long affair with, decided to call Uber for a ride to a local motel they'd booked for a romantic 30 minute getaway. The helpful Uber app noted that their driver was on his way to transport them to the love nest.

Upon arriving, they piled into the back seat of his car, only to have all parties immediately realize that the driver was actually Yeimy's husband, Leonardo, who was moonlighting that night by driving for a friend.

All parties immediately exited the vehicle.

It's unknown how many stars the driver got.



DATELINE: CALIFORNIA

A group of thieves stole $18,000 worth of industrial-use GPS tracking devices from a tech company.

Upon discovering the loss, the company remotely switched them on and saw the majority of the devices were in a warehouse, while 2 were still being driving around in cars. Police had arrested all involved and recovered the devices within 6 hours.

Police also noted the thieves had drunk a few beers they'd found during the robbery. One of them cut himself in process, leaving bloody fingerprints behind as additional evidence.



DATELINE: FRANCE

From the "A horse walks into a bar" department.


Monday, October 1, 2018

Formicidae

Frank is a college freshman this year, living in a dorm. Yes, you read that correctly.

So last Thursday I'm having a typically busy day of seeing patients when a text from him crosses the top of my screen.


Frank: Dad, I need to talk to you right now. There's a big problem here.

Dr. Grumpy: I'm with a patient right now. Can it wait 15 minutes?

Frank: Yes, but hurry.

After I finished my appointment with Mrs. Freenbeen, I called Frank.

Frank: "Um, hello? Who is this?"

Dr. Grumpy: "It's Dad. You told me to call you."

Frank: "Oh, that's weird. My phone said it was a call from a doctor's office. Are you sick?"

Dr. Grumpy: "No, I'm a doctor. I work here. What's up?"

Frank: "Oh, yeah. We have an emergency. Can you, like, go to the store after work and buy, like A LOT of ant bait traps and ship them to me overnight?"

Dr. Grumpy: "What's going on?"

Frank: "Me and Mike's dorm room is, like, FULL of ants. They're everywhere."

Dr. Grumpy: "I'm pretty sure you can buy bug poison at the Target across the street from you."

Frank: "Yeah, but then I'd have to pay for it."

Sigh.

Dr. Grumpy: "Why don't you let the building people know about this? They can have your room sprayed."

Frank: "Mike said he'd do that... Hey, Mike, did you talk to the RA about the ants?"

(mumbling in background)

Frank: "Never mind, Dad. Mike says the RA told him they'd have it sprayed later today. Hey, why do you think we have all these ants?"

Dr. Grumpy: "When was the last time you guys took out the garbage?"

Frank: "Um... I don't think we have. But, like, we only moved in on what, August 27th? How often should we be taking it out?"

That was a month ago. WTF.

Dr. Grumpy: "I'd say at least every week, if not more."

Frank: "That's stupid. There's still plenty of room under our beds for stuff. We moved the empty fast food and pizza boxes all under Mike's bed last week, after we put the dirty cafeteria dishes and forks in the bathroom sink."

Urp.

Dr. Grumpy: "Those things are what are attracting the ants!"

Frank: "Really? Why would they want that stuff?"

Thursday, September 27, 2018

History reruns - September 27, 1854





After the war of 1812 , the United States and Great Britain resumed commercial trade.

On both sides of the Atlantic, businessmen competed for their share of this increasingly lucrative business. Faster ships made more money, even if it meant going full speed into bad weather and poor visibility. Many ships vanished, forever listed as overdue, and presumed lost to bad weather and icebergs.

On the Eastern side, the driving force was Samuel Cunard. In the 1840's he came to dominate the Atlantic market, with the line that to this day bears his name. The British government backed him financially, so the ships could, in the event of conflict, be requisitioned by the navy (which they often were).

On the Western side, a number of American lines tried, with varying degrees of success. The U.S. government was less inclined to become involved in these matters, and so capital was harder to raise for building ships.

As sail gave way to steam, this changed. The Americans were concerned that Cunard's steamers could be converted to warships. Faced with both real economic and feared military competition, the government began backing various companies to try and win trade back from Cunard.

The man to lead this was Edward Collins. With government subsidies he built 4 large steamships (Arctic, Pacific, Baltic, and Atlantic), bigger, faster, and more luxurious than Cunard's ships, to challenge his rival. The plan was to run a tight schedule across the Atlantic.

The Collins Line ships, with their combination of sails and paddle wheels, were some of the fastest in the world at the time. They showed the Atlantic could be crossed in the remarkable time of 10 days, and in a few cases, 9.

Backed by their respective governments, Collins' and Cunard's lines competed intensely to dominate the 3000 miles of north Atlantic. Until 12:15 p.m. on this day.

As the Arctic steamed west, through a heavy Newfoundland fog, she collided with a small French ship, the S.S. Vesta. The Vesta, although much smaller, had a hull reinforced with iron.

In the first few minutes after the collision, many of the Vesta's crew assumed their damage was fatal, and abandoned ship (against orders) to try and reach the larger Arctic. They were wrong. The crew of the Vesta worked miracles and overcame the damage.

Captain James Luce of the Arctic was a veteran of the sea. Believing his own damage to be minimal, he turned the Arctic around to aid the Vesta, and launched 2 lifeboats to help evacuate it's passengers to the Arctic.

These orders were quickly canceled when one of the lifeboats reported the severity of the damage to him. The ship was badly damaged. Like the Titanic 58 years later, he had the legally required number of lifeboats. And they weren't nearly enough to hold everyone on board.

Cape Race was 4 hours away. With his duty to his own ship clear, Luce abandoned the Vesta, heading for land. His hope was to beach the ship before she could sink.

The wreck of the Arctic over the next few hours quickly turned into a nightmarish struggle for survival, very different from the civility seen in the Titanic. Captain Luce accepted that he and his 11 year old son (who was traveling with him) were going to die, and did his best to save passengers. He was betrayed by his crew and most of his officers.

His crew disobeyed orders, commandeered the lifeboats, and fled. A trusted officer and handpicked team of seamen were placed in a lifeboat so that passengers could be lowered down to them. As soon as they reached the water they rowed away, with plenty of space in their boat.

Without lifeboats, Luce and his few remaining crew did their best. They tore the wooden deck to pieces, frantically trying to build rafts. Doors were torn from hinges to be used for flotation. All furniture made of wood was assembled on deck in hopes of saving more lives.

Of 408 who sailed, there were 86 survivors (64 crew, and 22 passengers). Not a single woman or child lived. They're remembered by a monument in Brooklyn's Green-Wood Cemetery.

Captain Luce, surprisingly, survived. He and his son went down with the ship, but were ejected from the vortex as it sank. As they swam away, a large wooden paddle wheel cover broke loose from below the sea. It launched into the air like a rocket, then came down, killing his son. And yet, at the same time, it became a makeshift lifeboat for Luce and a handful of swimmers. They were picked up after a few days by a passing ship.

The loss was a disaster, both personally and financially, for the Collins Line. Besides Luce's son, the deaths included Collins' wife and 2 of their children.

Although mostly forgotten today, the disaster dominated headlines on both sides of the Atlantic for a month, until replaced by the Crimean War. It had the same effect then as the Titanic would in 1912. Safety specialists recommended specific East-West shipping lanes. Slower speeds and loud whistles in fog. Lifeboats for everyone. The majority of the recommendations were ignored until the aftermath of the Titanic.

2 years later, in 1856, the Arctic's sister, the S.S. Pacific, vanished en route from Liverpool to New York.

It was another blow for the Collins line. There was an economic recession, and the U.S. government was now willing to let Cunard have the Atlantic. Collins' subsidies were cut, and in 1858 his line folded. The surviving ships were auctioned off.

The wreck of the Arctic hasn't been found (to my knowledge no one has looked).

The Pacific was thought to have been lost to storms or icebergs in the north Atlantic. To the surprise of everyone, she was accidentally found in 1991 in the Irish Sea, only 60 miles from where she left Liverpool. Why she sank remains a mystery.

Cunard survives to this day, though is now owned by Carnival Lines.

Government subsidies for shipping, with the ships to be used in time of war, continued into this century in all the major powers.

The last American attempt to share the Atlantic trade lies, mostly forgotten, in Philadelphia. She is the liner S.S. United States, built with subsidies after World War II. The government paid for her huge size and (even to this day) remarkable speed, with the plan of using her as a fast troop transport in future conflicts. Her commercial career, like all liners, was doomed by the passenger jet. Multiple attempts continue to be made today to save her from the scrapyard.

Tuesday, September 25, 2018

Annie's desk

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

Mrs. Haddock: "Hi, I need a refill on my medication. It also has to be authorized through my insurance, because the last auth has expired."

Annie: "Okay, I can get started on that... you know, it looks like we haven't seen you since 2010."

Mrs. Haddock: "Wow. Time flies. Anyway, I'm going on vacation tomorrow, so can you please get this taken care of?"

Annie: "We can't refill meds on someone we haven't seen in 7 years, let alone get an insurance authorization. Who's been filling it?"

Mrs. Haddock: "My internist."

Annie: "Then you'll have to call him to get this refill, and make an appointment to re-establish with Dr. Grumpy if you want us to prescribe it."

Mrs. Haddock: "I haven't seen him in 6 months. He doesn't take my insurance anymore. It's National Illness, Inc."

Annie: "We don't take that, either, so we can't get an authorization for you."

Mrs. Haddock: "But I'm leaving TOMORROW! You need to call this in and get it authorized RIGHT NOW!"

Annie: "We can't do that, like I said, we haven't seen you in 7 years, and we're not contracted with your insurance."

Mrs. Haddock: "YOU'RE RUINING MY VACATION!"

click

Friday, September 21, 2018

The teenage mind

I'm sitting at my desk, about an hour before my first victim patient. My wife is at a meeting out of town, but fortunately the kids are old enough to drive themselves to school.

Then the text came in.

Craig: Dad. I'm locked out of the car. I need help.


What the hell? School started 20 minutes ago!


Dr. Grumpy: Ask Marie for her keys.

Craig: I can't. She's at school.


WHAT?!!! Okay, this isn't making sense.


Dr. Grumpy: Then where are you?

Craig: I'm at 7-Eleven.

Dr. Grumpy: Why are you at 7-Eleven twenty minutes after school started?

 Craig: It was an emergency! I had to get something for class! Do you have keys to the 4Runner?


Sigh.


Dr. Grumpy: Yes. Which 7-Eleven are you at?

Craig: The one at South Street and Central.


So I tell Mary I'm going to rescue Craig and will be back in a few. Fortunately, South & Central isn't too far from my office.

I get to South & Central, and Craig is nowhere to be seen.


Dr. Grumpy: Craig, I'm at the 7-Eleven at South & Central, and you're not here.

Craig: Well, I'm at a 7-Eleven. Maybe it's not that one.


I roll my eyes, take out my iPhone, and look up his location.


Dr. Grumpy: Craig, you're almost 3 miles away, at the 7-Eleven at 12th St. and Elm.

Craig: How was I supposed to know that? Please hurry, I'm going to get in trouble at school!


So I head over and find him there, standing outside the car. As I unlocked it he picked up two Slurpee's in a cardboard carrier and set them on the floor.


Craig: "Thanks, Dad. I'm sorry."

Dr. Grumpy: "It happens. What did you need for school, anyway?"

Craig: "The Slurpees."

Dr. Grumpy: "You left school to get 2 Slurpees? This whole thing was over a Slurpee?"

Craig: "Slurpees. I mean, yeah, Marie wanted one, too."

Dr. Grumpy: "Why didn't you get them at the 7-11 by the school?"

Craig: "I went there first, but they don't start making them until 10:00. But I remembered there was another 7-11 down here."

And he drove off.
 
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