Life is a highway

So, although my academic goal of medicine was to get through my career unpublished (which didn't quite happen), I still occasionally get dragged into research peripherally.

Let me be clear here that I have nothing against research. It's very important. It's just not my thing.

But my call partner, Dr. Cortex, loves it. So when she's out of town I occasionally get dragged into seeing a research patient for her, or signing off on some papers, or whatever. It keeps peace in the local neurology community.

Currently she's on one of her far-flung skiing trips (I think to Hoth this time) so I got roped into doing a pre-study screening visit on a lady for one of her Alzheimer's drug trials.

I showed up at the research office and sat down to look over some papers. There were 2 older ladies in the lobby. The study coordinator told me the visit had become a doubleheader, because the one who'd come in for it had been joined by another lady who'd heard about the study from her and also wanted to participate. Not a big deal. We need volunteers to find out what works, so the more willing souls the merrier. This is where all medical breakthroughs come from.

So I saw the first woman and did her paperwork, then went into another room to meet the add-on.

Dr. Grumpy: "Hi, I'm Dr. Grumpy. Thank you for coming in today. So, I guess you heard about the study from Thelma and decided to join her?"

Louise: "Well, she and I were talking on the ride over and she was telling me about it. I've also been diagnosed with Alzheimer's disease by a neurologist, so I thought I should get involved, too."

Dr. Grumpy: "Are you a friend of hers?"

Louise: "No, I'm her Uber driver."

Weekend On Call

On Friday I admitted a lady who fainted at the store. After talking to her I wrote "seizure unlikely" in my impression and wanted cardiology to have a look at her.

I then turned her over to my call partner, Dr. Nerve, for the weekend.

He apparently agreed with me, but is under the impression her insurance pays by the word. He wrote:

 

For this we invented the internet

An email saying you are about to get more email.

Thank you, Mike!

Life in these United States

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

Mr. Hatt: "Hi, I need to make an appointment with Dr. Grumpy."

Mary: "Okay... Sorry, we've gotten a lot of calls the last few days... our next opening for a new patient is in 2 weeks, on..."

Mr. Hatt: "TWO WEEKS? ARE YOU KIDDING ME? That's ridiculous!"

Mary: "I'm sorry, it's just been crazy this week. If you'd like I can make you an appointment and put you on a waiting list if anyone cancels?"

Mr. Hatt: "So how many of those people with appointments ahead of me are illegal immigrants?"

Mary: "Excuse me?"

Mr. Hatt: "I know you people give preferential treatment to illegals instead of real citizens. It's all over the news. So how many illegals are on your schedule ahead of me?"

Mary: "Sir, I don't know if any of them are, and I schedule people as they call in and the calendar fills up. There is no preferential treatment."

Mr. Hatt: "Oh, bullshit. I'm not that stupid. I bet I could call the DHS and they'd clear out your lobby in a heartbeat. Actually, they probably wouldn't, since they favor them, too."

Mary: "Okay, I'm going to hang up the phone now."

Mr. Hatt: "So you're an illegal, too? Figures."

 click

1-star review

Craig and his team are at an out-of-state competition, representing Big State University. The other night I was dozing off when he texted me.

 

Unsolicited offer

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

Mr. Ink: "Hi, I'm Mike Ink. I have some extra rooms at my place and was hoping to sublease them to a doctor looking to expand his practice with a satellite office. I was wondering if you're interested?"

Dr. Grumpy: "No, thank you. I try to keep it small."

Mr. Ink: "Do you know any other doctors who might be looking to expand?"

Dr. Grumpy: "I can give them your name. What kind of practice do you have?"

Mr. Ink: "Well, technically it's not a medical practice, it's a tattoo parlor."

No comment

 

Memories

Following our first year of medical school, my roommate Enzyme and I returned to our home states for the summer. He (of course) found a girlfriend.

Enzyme saw it as just a summer fling, but failed to properly communicate this to her before returning to school (he claimed he had, and that she was crazy). Regardless, she had our apartment's phone number when he returned to school, though fortunately was over 1,000 miles away (back in those days, kids, you actually had to CALL people. Not e-mail or text. And you didn't each have your own phone, either).

So, in the time-honored tradition of single males sharing a cave, it somehow fell to the roommate (me) to answer the phone so he could hide. As many people of both sexes before him, he was hoping that if he ignored the calls, she'd stop calling. And we all know that never works.

I couldn't just ignore the phone, it might be for me.

So one day, as the phone started ringing, I said, "Enzyme, this isn't working. She's still calling." He agreed, and told me to try something else to get rid of her. Of course, he didn't offer any suggestions, either.
 

 
I answered the phone...


Medical Student Grumpy: “Um, hello?”

Summer Girl: “Hi! Is Enzyme around?”


...my mind went completely blank. I couldn't think of a single thing to tell her that might make sense, like "Enzyme has broken up with you."


Medical Student Grumpy: "Um, he, um, I mean..."


I had a complete mental block. Not one idea jumped to mind.


Summer Girl: "Hello? Are you still there? Can I talk to Enzyme?”

Medical Student Grumpy: "Enzyme, um, he, uh... Enzyme is dead."

Enzyme (whispering): "Holy CRAP! Don't tell her I'm dead! She might call my mom's house!"

Summer Girl: "Excuse me, did you just say Enzyme is dead?"

Medical Student Grumpy: "No, I mean, he's, um, he's... gay."

Enzyme (whispering): "WHAT THE FUCK?!!!"


Long pause.


Summer Girl: "So. Is he dead or gay?"

Medical Student Grumpy: (dazed and stammering) "Um, he's either dead, or gay, I don't remember which..."


Enzyme took the phone out of my hand and hung it up.

Although it wasn't planned that way, it worked. He never heard from her again.

Modern technology

Dr. Grumpy: "Okay, so did the medication make a difference?"

Mrs. Timex: "Sort of, it..."

phone beeps, patient looks at watch

Mrs. Timex: "OH MY GOD! CALL 911!"

Dr. Grumpy: "What? What's wrong?"

Mrs. Timex: "MY WATCH SAYS MY HEART JUST STOPPED!"

Dr. Grumpy: "I don't think that's accurate..."

Mrs. Timex: "Of course it's accurate! I just got it last week! Call 911!"

Dr. Grumpy: "I can assure you that your heart hasn't stopped."

Mrs. Timex: "HOW DO YOU KNOW? You haven't even made a move to check my pulse! Or call 911!"

Dr. Grumpy: (picks up blood pressure cuff) "Let me..."

Mrs. Timex: "This is ridiculous! My heart has stopped, and you're not doing anything! I'm driving to ER!"

she ran out

Mary's Desk

Phone rings

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

Mrs. Brush: "Hi, this... Brush... appointment... won't be able... there."

Mary: "Hello? Mrs. Brush? I can barely hear you. There's a lot of noise."

Mrs. Brush: "I... appointment."

Mary: "You have an appointment in 10 minutes. Is something wrong? It sounds like you're in a big storm."

Mrs. Brush: "Won't be there... stuck."

Mary: "Hello? That wind and rain are pretty loud. I can't hear you."

Mrs. Brush "I..."

 

click

few minutes pass

phone rings

 

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

Mr. Brush: "Hi, this is Mr. Brush, my wife just texted and asked me to call you. She has an appointment soon and won't be able to be there, she'll call later to reschedule."

Mary: "Is she okay? It sounded like she was driving through a bad storm. Did she have to leave town?"

Mr. Brush: "She's fine. She stopped to get a car wash on the way there and it broke and now her car is jammed in it and they can't turn it off to get her out for another 15 minutes."

We seem to be made to suffer.

Dr. Grumpy: "I didn't get that report... I'll try to track it down. Did they tell you what the MRI showed?"

Mr. Daniels: "There was a herniated disk at C-something. Ummm... Maybe C3-PO? Does that sound right?"

Saturday night, 11:45 p.m.

"Hi, this is Sara Phone. Your nurse called the other day and asked me to call back or leave a message on how I'm doing, so I am, thank you."

Random pictures

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

 

First we have this festive jewelry for the holiday season. Because nothing says "Christmas" like a, uh, "Christmas tree."

Next we have this pasta. It's not only artisanal, but it's also shaped like New Jersey. Talk about a win-win!

While we're on the food topic, here's a car decal that asks "What would Jesus cook? And why wasn't it being served in The Last Supper?"

The there's this place, which makes you wonder if the guy cutting your hair works naked. Based on the barbers I've been to, I probably wouldn't go there.

And, lastly, is this article. The fact that it's filed under "meat industry" is kind of unnerving.

 

Friday

An attorney I've worked with called late Friday morning. A demented homeless patient had been found living in a culvert, completely disoriented. There was no known family. The small hospital he was at didn't have a neurologist available and they needed one to evaluate cognitive status for legal reasons. Would I be willing to do it?

My afternoon was actually fairly empty, as Fridays tend to be. So he emailed me the necessary paperwork and releases and I set off across town. After the usual COVID swab, then getting lost trying to find the correct room, I was there.

He was in his late 70's. The nurses had done an excellent job of cleaning him up (nurses deserve far more credit for this sort of thing than they ever get). Now he was in a hospital gown and adult diapers, still smelling slightly of urine, mumbling on and off, and occasionally asking me what school we were in.

I examined him, then sat down with his chart and some old medical records that had been scrounged together, looking to make sure the right things had been checked and ruled-out, the usual stuff that's second nature at this point in my career. I filled out a few papers, scanned them with my phone, and sent them off to the lawyer. I was done.

As I stood up to go I noticed a small pile of random objects on a chair in the corner and realized they were what had been found with him. His only worldly possessions, as the phrase goes.

Curious, I looked them over. A few T-shirts, a pair of socks, a metal water bottle and 2 plastic ones, some unopened bags of candy, 2-3 small stuffed animals. Somewhat incongruously there was a framed picture of a group of 5 men, all in 1970's-ish business suits and ties, standing behind a conference table, all smiling. The table had some scattered pens, note pads, coffee mugs, and a telephone. There was no name or date. The guy 2nd from left was the one lying in the bed behind me.

I have more things than he does, but neither of us gets to take them with at the end.

Out of all the items in the small pile, the picture obviously meant something to him. It was about 8" x 10", and certainly not easy to hold on to through all changes that a life of homelessness brings. But of the things that had connected him with who he'd once been, that was the one he wasn't going to get rid of. Even in the waning shadows of Alzheimer's disease he still thought it was important.

It led me to wonder how he'd reached the current situation. But the possibilities are large, varying from bad decisions to just the terrifying bad luck that can hit any of us. I had no way of knowing, nor was I going to guess. That's not what I was there for.

The things in that small pile were the only ones of value left to him. I suspect the photo was the most prized, simply because, unlike everything else on the chair, it couldn't be replaced, and he'd kept it for 40-50 years.

The detritus of a human life.