1:47 a.m.

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

Mr. Lacune: "Hi, thish ish Dave Lacune, you shaw me at the hoshpital a few days ago, when I had a shtroke."

Dr. Grumpy: "Yes sir, are you okay? Your speech is pretty slurred, and I don't remember it having been affected by the stroke."

Mr. Lacune: "I'm fine. Look, you preshcribed Nomocva to me, to keep me from having another a shtroke, but I read about all itsh shide effectsh, and sho now I shtopped it and I'm afraid to take it."

Dr. Grumpy: "I'm kind of concerned you've had another stroke, sir. Your speech is pretty slurred."

Mr. Lacune: "Nah, my shpeech ish like thish because I've been doing tequila shotsh and shmoking weed all night because I'm anxioush."

Pause

Dr. Grumpy: "What are you so anxious about?"

Mr. Lacune: "Becaushe I shtopped Nomocva, sho now I'm worried I might have another shtroke."

Seen in a hospital chart

 

Second opinion

Dr. Grumpy: "Let's see... At your last visit I prescribed Flipazol. Did that help?"

Ms. Webb: "No, it didn't do anything."

Dr. Grumpy: "Were there any side effects?"

Ms. Webb: "There were a lot of them. It was terrible! I can't believe you prescribed it for me!"

Dr. Grumpy: "What happened?"

Ms. Webb: "Actually, I never even had it filled. I didn't like all the side effects I read about."

Dr. Grumpy: "Then why did you say it didn't help you?"

Ms. Webb: "A lady I met online told me it wouldn't."

Memories

In the early 1970's, my mom was found to have breast cancer. I was too young at the time to really understand it, and fortunately she's still around.

Anyway, she had a right mastectomy. At the time they waited about a year before they'd put in a breast implant, so during that time she used a prosthetic boob. She'd put it in her bra before leaving for work, and take it out when she got home.

Anyway, there was one day where she had a lot of errands to run, and when she got back was telling my dad how, everywhere she went, she got some strange looks. Nothing horrible, just people seemed surprised. She figured it was something she was wearing, or a large food stain on her blouse, or whatever.

My dad took her down the hall to their bathroom, where she'd left the fake breast lying on the counter.

Random pictures

 Okay, time to put up some stuff you guys have sent in.

First is this pizza place. I can only assume the owner isn't familiar with idioms. Either that or he's trying to keep the place empty.

 

Next, from the "nudge nudge, wink wink" department:

"Only $32? Is that at the same time?"

One reader wants to know why the Slurpee looks like the poop emoji.

 

Another says this beauty salon couldn't look more disreputable if it tried:

 

 

 

And lastly, a reader says he ordered a brisket sandwich with onions, and wished they'd abbreviated it differently.

Beep. Beep. Beep.

Dr. Grumpy: "Do you drive?"

Mr. Safety: "Oh, hell no. My seizures have been so unpredictable that I've given it up."

Dr. Grumpy: "Were they ever well-controlled?"

Mr. Safety: "They were good, but not great. It always seemed like one would occur when I'd just started to think they were controlled, and I'd have to stop driving again. I finally gave it up. It just wasn't safe for me, and I don't want to hurt anyone else. My friends and I all work at the same warehouse, so I just carpool with them and chip in gas money each week."

Dr. Grumpy: "That works out. What do you do over there?"

Mr. Safety: "I'm a forklift operator."

Blink

She was 19, here for migraines. She was nervous, had never been to a neurologist before, and her mother was along for emotional support.

We talked a bit, went over some treatment options. Nothing too costly. She worked full-time as a waitress, trying to save money so she could start college soon. We settled on nortriptyline and naproxen, and I began writing out scripts.

As I scribbled, I blinked.

Suddenly the scripts were gone. Instead of paper, I was typing in an online refill for generic sumatriptan… which a minute ago was brand-name, and she couldn’t afford it.

She was still there, across my desk, but she’d changed, too. She wasn’t a waitress anymore. She was working full time as a nurse, was married, and had two daughters. I remembered her having moved away to go to college, then nursing school, then coming back here. I recalled her telling me she'd gotten engaged. I’d treated her migraines through both pregnancies.

The nortriptyline hadn’t helped, and now she was on Aimovig, a drug I hadn’t imagined when she first came to me. In the time between then and now, besides the times she lived out-of-state, I recalled trying a handful of different medications over the years.

During my blink she’d developed a few gray hairs, wrinkles, and pounds from the stresses of daily life, jobs, raising a family, and making ends meet. I’m sure mine are worse.

This is also part of medicine, just as it is in everyday life. Over our careers we see college students mature into adults with jobs and families. We see parents become grandparents. The middle-aged become elderly.

We see people we’ve grown to care about die of things we can’t fix.

Being a doctor reflects the changes we see in our own lives as we travel around the sun. Our patients become a sort of extended family. We aren’t directly involved with their daily events, but we catch up on them here and there, and they see the same changes in us.

The drawings my kids did are still on my office walls, but haven’t been updated in a long time. Picking them up from the after-school program has been replaced by picking them up from the airport.

My hair has gradually thinned over time and become grayer.

The glasses I’ve worn since I was 8 have become bifocals.

All in a blink.

Mary's desk

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

Mrs. Frantic: "Hi, I have an urgent issue and need to get in RIGHT AWAY!"

Mary: "Hang on... Okay, the doctor can see you this afternoon, at 4:30... we also have an opening at 8:15 tomorrow morning, or..."

Mrs. Frantic: "Those won't work, um, I, uh, I'm actually out-of-town, on vacation, for another 2 weeks."

Pause

Mary: "Okay, when will you be back?"

Mrs. Frantic: "I don't have my work schedule here. Can I just call you after I get home?"

Seen in a chart

From an internist who apparently believes in "brevity is the soul of wit."

 

 

You  just know he billed this as a high-level visit, too.

Thank you, L!

Probably true

Dr. Grumpy: "Okay, then let's try increasing the dose of Flurpizol to 2 pills each night."

Mr. Martin: "That's what Annie had told me to do when I called last month, "

Dr. Grumpy: "I was wondering about that, because I see the phone call listed..."

Mr. Martin: "You're not angry at me, are you? I just wasn't sure."

Dr. Grumpy: "No, of course not. Let's just try the increase now and we'll see..."

Mr. Martin: "You're not going to tell Annie, are you? I don't want her to be angry at me, either."

Dr. Grumpy: "She won't be. Don't worry about it."

Mr. Martin: "Do you promise? Isn't she your boss?"

Medical advertising

Saw this ad in a journal a while back.

It was, I believe, for a back pain treatment. Though I can also see it being used for a martial arts movie. It it were in black & white it could even be something by Robert Mapplethorpe.

But what I really love is the obligatory "Not an actual patient" disclaimer, as if it were common for patients with a metal clamp on their low back and jagged metal protruding from their skin to come in for an appointment (my colleagues in ER may feel differently).

If they did, I'd probably have to turn them away. I couldn't afford the upholstery damage.

Patient quote

“Sorry if my speech is slurred, doc. I was really nervous about the appointment so I took 2 Vicodin and some marijuana gummies while I was driving over."

Moms

Dr. Grumpy: "What medications have you tried for this?"

Mr. Teen: "They... I'm sorry, my mom wrote them all down and I left it at home... Hang on."

Pulls out his phone.

Mother: "Hello. You left the list on the counter here."

Mr. Teen: "Yeah, can you read it off, please, I'm with the doctor."

Mother: "I swear, you'd forget your ass if it weren't attached to you. Remember the thing last week, where you sent a tube of athlete's foot cream through the wash? You need to be more responsible."

Mr. Teen: "Mom, can you just tell me what medications..."

Mother: "I had to replace your father's work shirt, young man. And I bet you got there late for the appointment today, too? Dr. Grumpy, can you hear me? Was he there on time?"

Dr. Grumpy: "Uh..."

Mr. Teen: "I think one of them was Excedrin, and another was called sumaframtam, and..."

Mother: "He means sumatriptan, doctor."

Mr. Teen: "Mom I can't hear you, it keeps cutting out."

He puts the phone in his pocket.

Mr. Teen: "I'll call you with the list after I get home."

Burning down the house

Hi, it's Craig, reporting from Local Grocery.

On Friday night I was doing the usual pre-closing routine in the bakery, sweeping up crumbs, washing out baking trays, making sure no one was locked in the freezer, when suddenly the night got more lively.

One of my colleagues working in deli opened their oven to have flames shoot out of it and set some surrounding materials on fire.

In a large store this occasionally happens, and we're trained for it, so I didn't panic. In fact, the only thing that happened in my department was a lady came over and asked if I could get her 1/2 pound of honey-baked turkey since the deli staff seemed kind of busy (no, I can't).

Then the deli manager suddenly yelled to me "I need your fire extinguisher!"

I grabbed it off the decorating table and ran it over to him. He put out the fire at the same time that the deli's sprinklers switched on, soaking all of us and the lady yelling about honey-baked turkey.

Since the bakery was quiet I helped them mop up while somebody dealt with the turkey lady (who was now also upset over her unexpected participation in wet-floral-print-polyester-blouse night). I was back to boxing up unsold donuts for the homeless shelter pick-up when the deli manager came over.

Deli guy: "Thank you, we really needed that, we couldn't get to ours. I've put in an order for a new one for bakery, and it will be here tomorrow."

Craig: "Thank you. Where is your fire extinguisher?"

Deli guy: "We keep it on the wall behind the oven."