Quote of the day

"I was in the ER last weekend for a seizure. They said my Dilantin level was 8. Or maybe it was 18, or 28. I don't know, it was a number with an '8' in it. Does that help?"

Anatomy

Garlic, like a lot of old dogs, is covered with random lumps, bumps, and warts.

This past weekend Craig was having a party (actually, Craig seems to have a party every weekend, but that's another post).

As usual, Garlic and Onion were making the rounds, hoping to snag a pretzel or fallen cocktail weenie. At one point one of Craig's entourage groupies harem friends began petting Garlic, so he hopped up on the couch next to her to keep the attention coming.

A few minutes later she noticed me wandering out of my office to get a Diet Coke and came over to ask...

"Hi, uh, Mr. Craig's dad. How come your dog has nipples growing out of his back?"

Check out

I was on call for the weekend, so Sunday night had the usual check-out call with Dr. Cortex:


Dr. Cortex: "Hello?"

Dr. Grumpy: "Hi, it's Grumpy."

Dr. Cortex: "Okay, let me get my list and a pen..."

Dr. Grumpy: "How was your weekend? You guys do anything?"

Dr. Cortex: "We took the grandkids to the annual air-show, but, one of the planes crashed while landing. They said the pilot was killed and the passenger badly injured. Fortunately, we were at the snack bar when it happened, so Billy and Dolly didn't see it. But it must have been horrible. We left right away."

Dr. Grumpy: "I don't blame you."

Dr. Cortex: "All right, I'm ready for the list. What have you got for me?"

Dr. Grumpy: "Okay. In the ICU, room 37, is a guy with a serious head injury. He was a passenger in a plane at the air show......."

Thud

Dr. Grumpy: "Did you have those labs done?"

Mr. Siphonaptera: "Hell no. I walked out of the lab. They treated me like crap."

Dr. Grumpy: "What happened?"

Mr. Siphonaptera: "The girl at the front desk told me she was going to have me see a phlebotomist, which is bullshit. I don't have fleas. So I left."

11:38 p.m.

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

Ms. Papaveraceae: "Hi, I'm a patient of Dr. Brain's, and I ran out of Percocet. My pharmacy number is..."

Dr. Grumpy: "I'm sorry, but I don't call in controlled drugs after hours. You'll have to contact Dr. Brain's office on Monday."

Ms. Papaveraceae: "But I really need it!"

Dr. Grumpy: "I can't call in any narcotics. What I can call in is..."

Ms. Papaveraceae: "But I can't take anything else because of religious reasons. I belong to a small sect that worships poppy flowers, so..."

Dr. Grumpy: "I'm not calling narcotics in."

Ms. Papveraceae: "So you're discriminating against me on the basis of my religion? I will get an attorney and..."

Dr. Grumpy: "Have a good night."

Click.

Relevant

Last week I received a letter from a research company, looking for "experts in a specific field."

It asked if I could answer "yes" to any of the following questions:

In Memoriam

 
My kids have now passed one of the milestones of modern adolescence.

The death of your first car.

The boys aren't having much of an issue with this, but Marie is taking it vary hard. The 4Runner was her baby.

You may remember her adventures with the car, when she outraced her older brothers to be the first with a license. The Toyota was 19 years old, with 265,000 miles, but she loved it. For reasons known only to her she named it "Dakota," which she insisted on spelling "decoda."

And, fittingly, it died with her at the wheel.

Rolling down the freeway on her way to an off-campus class, it suddenly began shaking wildly under her and making a racing noise. Alarmed, she took her foot off the gas and started to pull into the emergency lane. Then there was a loud "BANG!"

The engine stopped, never to turn again. As she came to a halt, Marie noticed a lot of fluid and some pieces of metal in the road behind her.

Since nothing fazes Marie, she calmly called AAA to arrange a tow, only bothering to notify her parents of this change in events when AAA asked where they should haul the car.

The next morning the guy at the car place asked if I could swing by on the way to work. Taking me into the garage, he showed me a jagged hole in the engine block the size of a football. As I marveled at it he handed me a chunk of metal that used to be piston, and pointed out where he'd found it embedded in the undercarriage.

I thought it looked like a femur. Keys are for size comparison.

So, after circling the globe 10.5 times, the car is being donated to charity.

We went to the repair shop before it was towed away to strip it of our personal stuff. This included $5.82 in coins scattered in cup holders, seat cushions, and under floor mats.

Marie carefully pried the 4Runner nameplate off the back, and it's now hanging in her bedroom, next to the hunk of piston.

I'd have to agree

I'd just finished doing an EMG/NCV on a patient.


Dr. Grumpy: "I hope that wasn't too bad."

Mr. Needle: "Nah, it went fine."

Dr. Grumpy: "Good."

Mr. Needle: "Yesterday they stuck a camera up my dick. That was much worse."

Seen in a chart.

If this MRI finding is correct, it's a publishable case.

 

My readers write

I'd like to thank the person who sent in this allergy list:

"Really? I have more trouble with their teeth and claws myself."

You don't know jack

NOTE: the following is NOT an April Fool's Day joke.

I'd like to thank the Science Marches On Department for sending me a truly remarkable piece of research.

Scheduling in a medical clinic requires talent, skill, and magic. There's only so much time in a day, and a lot of patients who need to be seen. People often portray the front-desk wizards as brainless, but they're far from it. Mary, after 14 years, knows me and my patients. From a few seconds on the phone she can get a good idea of how much time any particular patient will need, how that meshes in with the rest of my schedule, and (based on history) how long I am with any given return.

She also has to figure in how long it take takes me to grab a Diet Coke and drain a previous one between visits.

Any practice faces this issue, so obviously some research goes into improving work flow.

A study out of Miami, Florida recently looked into this important subject to calculate times needed for appointments at a fertility clinic.

Specifically, how long it took for a guy to, uh, shake hands with the milkman.

Yes, they wanted to know. That.

In the study guys were given a donation cup and unnamed porn mag. A stopwatch was started at the time they entered the room. They then took matters into their own hands, and texted "done" to the stopwatch person after the research project had climaxed.

For privacy, the exam room had a curtain. Boy, that's a relief.

Admittedly, it sure beats the idea of having a burly orderly with a timer in there, watching you box the one-eyed champ, but still.

The study makes no mention if the guys were allowed to wash their hands before picking up their phones to text the desk afterwards.

This graph is, by far, the best part of the article. It shows how long a guy takes to let it fly while pumping gas vs. the number of patients seen that day.

Note the blue bars: some guys actually had their ladies in the room during the process, although, under the fertility protocols, they weren't allowed to have physical contact. So the bottom line is that, if someone is watching you polish the banister, it will take longer to finish the job. In fact, the ONLY guy in the study who was unable to successfully finish marching the penguin was one who had his girlfriend in there.

Who could have seen that coming?

You can read the study itself here. It has pictures of the exam room, and a porn mag with a brown paper cover on it.

Thank you SMOD!

Spring break

Taking a few days off for kid stuff. See you next week!

Musical Gobstopper

For those of you who somehow haven't seen the totally awesome SNL "Bodega Bathroom" musical number, here it is. You're welcome.

11:52 p.m.

I'm sound asleep when my iPhone rings. It's my call partner, Dr. Cortex.

Dr. Grumpy (mumbling, trying to wake up): "This is Dr. Grumpy."

Dr. Cortex: "Hi, it's Cortex."

Dr. Grumpy: "Why are you calling? Aren't you in the hospital for hip surgery?"

Dr. Cortex: "Yeah. Hey, did you round on my patients today?"

Dr. Grumpy: "Yes."

Dr. Cortex: "Did you see the guy in alcohol withdrawal in room 6824?"

Dr. Grumpy: "Yes, why? I think I ordered all the usual tests."

Dr. Cortex: "Because after I left recovery they put me in the room next to him, and he's screaming nonstop and I can't sleep. He's driving me nuts. I'm going to put you on with his nurse now, so you can order something to sedate him."