Chief complaint

My colleague, Dr. L., says she's studying for her neurology boards, and was taking a practice test last weekend.

This question was on it, and she says she's never had a patient report answer E to her.

I'd have to agree. At least not without a Ouija board.

Thank you, Dr. L!

Thanks, Sherlock

A drug rep marketing an epilepsy medication brought lunch in for Pissy and I, so we were having the usual 30 minutes of catered sandwiches and pamphlets full of glossy pictures, graphs, and small print.

As we talked, she mentioned that, as part of her new-hire training, she was sent to volunteer at Camp Shaking Pines this past summer. This is a summer camp held for children with epilepsy who, for medical reasons, can't go to other camps. The purpose of her 3 days there was to "raise my awareness" of epilepsy.

Then she said "Doctor, do you know that some of those kids, the ones with seizures, will actually have seizures, right there, at seizure camp?"

I heard a thud behind me as Pissy's hand hit his face.

Breaking news!

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

DATELINE: LONDON

British police have apologized after what they previously described as a "huge drugs bust" turned out to be vegan cake mix.

Staff of Purezza, a vegan restaurant, were transporting a large amount of vegan cake mix in a suitcase when it was confiscated at Gatwick airport by transportation police.

After identifying the powder as cake mix, the bags were returned to the restaurant. The staff has offered the police free cake, though at press time the police haven't accepted.



DATELINE: NEW JERSEY

An 80 year-old woman had her vehicle stolen. While she was asleep in it.

Police say the lady had dozed off after parking her car, and when she woke found herself lying in the driveway. She had no recollection of being taken out of the car.

The car has since been recovered.



DATELINE: NORTHERN CALIFORNIA

No one was injured when a bear landed on a police car.

In an unusual chain of events, a Humboldt county sheriff's deputy was driving on Route 96 when a bear fell off a steep embankment and landed on his patrol car. The hood and windshield were smashed.

The surprised officer lost control of his bearmobile, which slammed into the embankment, rolled onto its side, and burst into flames.

This resulted in a small forest fire, that burned about half an acre.

The officer was unharmed.

The bear fled the scene, and was not available for comment.

Uh...

Today's post is dedicated to the marketing genius at Boehringer-Ingelheim pharmaceuticals who came up with this name for their veterinary portal:

Good luck on your job search.

Thank you, Webhill!

Free samples

Mr. Dixie: "Hey, doc, do you need to check levels on my seizure medication today?"

Dr. Grumpy: "No, I don't."

Mr. Dixie: "You sure? Like, need a urine sample?"

Dr. Grumpy: "No, and it would be blood, anyway."

Mr. Dixie: "Oh... Well, I thought you might, so I left a cup full of piss out in your lobby bathroom, just in case. It has my name on it."

Dr. Grumpy: "Um, we don't have sample cups out in the lobby bathroom?"

Mr. Dixie: "I know. I took it off your water cooler."

Big Donor

Dr. Grumpy: "How you doing today?"

Mr. Big Donor: "I'm tired. You wouldn't believe what happened to my daughter's husband last night."

Dr. Grumpy: "He okay?"

Mr. Big Donor: "My son-in-law, Todd, was hanging up some pictures last night and accidentally hammered his thumb. It was really killing him. Maybe he broke it. He ended up having to go to ER."

Dr. Grumpy: "Ouch. That must have hurt."

Mr. Big Donor. "So he finally went there around midnight, and they left him sitting in the lobby. He said they kept bringing all these people from ambulances in ahead of him, and this one lady who had something stupid, like chest pain, got taken right back."

Dr. Grumpy: "  "

Mr. Big Donor: "So he finally called me when he remembered I'm on the hospital foundation's board. I was so angry. I called Dr. Brown... you know him? He's CEO over there? I have his home number and woke him up and told him about this bullshit they were doing to Todd. He took care of it, and they got Todd back in the next 5 minutes. But it's such crap that I even had to do that. I mean, I'm not a doctor, but even I know how a health care system should work. But the dimwits in ER have no clue."

Seen in a chart

I have no idea what this means, or why it's listed as a therapy.

Memories...

About 10-15 years ago, there was an internist who took night call doing hospital admissions. He worked from 5pm - 7am, and I was usually there from 5am to 6pm, so we encountered each other a fair amount toward beginning and end of day.

He was an eccentric dude (though a good doc), the type who tends to be best working night shift. He always had a large briefcase with him. Everywhere. It never left his side. No one but him knew what was in it, was never seen open. He took it in patient rooms, the bathroom, the doctors lounge... everywhere.

Late one afternoon I got called to see a guy admitted for a minor stroke. He was a retired baseball Hall-of-Famer. So I went in, and was talking to he and his wife, doing my usual neurology stuff.

I’d just finished answering their questions when Weird Doc and his huge briefcase wandered in to do the admission. He came in, set the briefcase down. I handed him the chart, since I was done with it and headed for my next consult. He glanced at it, then said “OH MY GOD! YOU’RE MIKE HOMERUNSLAMMER! CAN I PLEASE HAVE YOUR AUTOGRAPH?”

He opened the briefcase. I may have been the only person on Earth (besides him) to have seen its contents. It was crammed full - and I mean REALLY full - of baseball cards. I'd never seen so many. All neatly arranged by teams and years.

He rummaged through it and pulled out the guy’s card from some year. And a pen. And a clipboard. and handed them to the patient. Somewhat stunned (I was kind of in shock myself) he signed it, handed it back, and the briefcase was closed.

Then he pulled his stethoscope out of his pocket and started business. "Thank you! So, what brings you to the hospital today?"

"I'll take that as a yes."

Dr. Grumpy: "Did you have a headache when these other symptoms occurred?"

Ms. Patient: "Well, I believe I may have, if that was my awareness of how I felt was to have had a headache at the time than it could have been that I was possibly aware of having a headache."

Fun with EMR

I went to look up a patient's blood pressure trend at the hospital, but only found this:

People's lives depend on this, too. Don't that just make ya feel good?

Overheard

I get in the hospital elevator with a 30-ish woman who's talking to someone on her cell phone. I hear:

"No, seriously, Sue, all the doctors here are idiots. Nurses, too. I mean, they tell me stuff about Mom's condition and tests and stuff, and I google it, and it always says the opposite of what they're saying. This place is a deathtrap. I'm trying to get her transferred somewhere else, where people know what they're doing."

Love and marriage

While on call last weekend, I was trying to track down a few victims patients when I noticed my call partner's (Dr. Nerve) wife was in one of the rooms on the floor. So I went in to say hi.

Dr. Grumpy: "Hi... Wow, that's a big cast. What happened?"

Mrs. Nerve: "He talked me into going on one of his overnight hikes-to-hell yesterday, in Southstate Canyon. About halfway through I tripped on a rock and broke my ankle."

Dr. Grumpy: "Holy crap. Are you okay?"

Mrs. Nerve: "Yeah, they operated on it last night."

Dr. Grumpy: "That's a pretty remote area. Did he have to carry you out?"

Mrs. Nerve: "No, they sent a helicopter and airlifted me here. We were WAY off the regular road."

Dr. Grumpy: "Where is he?"

Mrs. Nerve: "No idea. After I broke the leg he called for the helicopter and left. He said he was going to finish the overnight hike, and would meet me back here today."

Random pictures

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


First, from the "what the hell does that mean?" files:

In the build-up to July 4, one reader noticed that this lonely fire-extinguisher isn't particularly reassuring if the whole pile goes up:

Then we have this sign, from the "look, I said it already" department:

Apparently the Utah Shakespeare festival is presenting one of the Bard's more popular works:

I'm guessing this newsflash was written by someone who really loved "Death Race 2000"

Reader A writes that her mother's recent attempt at baking bread came out vaguely obscene:

Another got this offer on his phone, and says that he personally wouldn't drink any product whose name sounds somewhat like "diarrhea."

Dr. K says that when he and his family were at a resort last month they put this up before Father's day:

And, lastly, it's kind of scary they have to remind people not to do this:

Helpful

Not-so-great moments with using Epocrates: