Annie's desk

Phone person #1: "Thank you for calling Low-Cost Radiology, where our prices reflect our quality every day! Can I help you?"

Annie: "Hi, this is Annie, at Dr. Grumpy's office. I'm trying to get insurance approval for a patient to have an MRI there, and to submit the form I need your facility's tax ID number."

Phone person #1: "What's a tax ID number? Is it how much we paid in taxes? Last year I paid..."

Annie: "No, it's the number your facility is assigned for tax and business purposes. The insurance companies need it so they can pay you for the MRI."

Phone person #1: "Is that the same as my social security number? I can give you that. It's 738..."

Annie: "No. It's the assigned..."

Phone person #1: "Let me transfer you."

 

On hold with a subdued piano & cello version of "Smells Like Teen Spirit."

 

Phone person #2: "Thank you for holding. Can I help you?"

Annie: "Hi, this is Annie, at Dr. Grumpy's office. I'm trying to get insurance approval for a patient to have an MRI there, and to submit the form I need your facility's tax ID number."

Phone person #2: "Hmmm... Is that the number you just called to reach us?"

Annie: "No, that's your phone number. It's..."

Phone person #2: "Oh, is that like a special number the IRS calls us on?"

Annie: "No it's..."

Phone person #2: "Let me transfer you."

 

On hold with a subdued piano & cello version of "Safety Dance."

 

Phone person #3: "Thank you for holding. Can I help you?"

Annie: "Hi, this is Annie, at Dr. Grumpy's office. I'm trying to get insurance approval for a patient to have an MRI there, and to submit the form I need your facility's tax ID number."

Phone person #3: "I don't think we have one."

Annie: "No, you do, every business has one, it's assigned to you before you open by the..."

Phone person #3: "Let me transfer you." 

On hold with a subdued piano & cello version of "Paint It Black."

 

Phone person #4: "Thank you for holding. Can I help you?"

Annie: "Hi, this is Annie, at Dr. Grumpy's office. I'm trying to get insurance approval for a patient to have an MRI there, and to submit the form I need your facility's tax ID number."

Phone person #4: "Oh, hang on. Let me look that up for you. Hmmm. I thought I had it on a Post-It note somewhere... maybe it's behind the take-out menu for Blumenthal's Chinese... no, maybe it got stuck to the menu for the place we ordered lunch from on Monday, I can't remember the name though... that may be over by the fax machine with the Chipotle forms, hang on... you know, I may have accidentally thrown it out because a bunch of stuff got marinara sauce on it when I was eating yesterday... let me transfer you."

 

On hold with a subdued piano & cello version of "Girls Just Wanna Have Fun."

 

Phone person #5: "Thank you for holding. Can I help you?"

Annie: "Hi, this is Annie, at Dr. Grumpy's office. I'm trying to get insurance approval for a patient to have an MRI there, and to submit the form I need your facility's tax ID number."

Phone person #5: "I hate you phishing scams. Fuck off."

click

Current status

Sir, if you don't stop tapping "Rock Lobster" out on my desk with your horribly untrimmed fingernails I am going to have to kill you with a Trömner.

Fore

Mr. Lewy was brought in by his son.

 

Dr. Grumpy: "So, what happened? I mean, I spoke to the police earlier, but want to..."

Son: "A neighbor called the police, Dad was chasing invisible people down the street, screaming at them and waving a golf club."

Mr. Lewy: "There were people all over the house! And in my yard! And they were having a party, and I told them to leave, and they wouldn't! So I told them to get out or I was going to clobber them, and when they didn't I chased them outside and down the street!"

Son: "The police calmed him down and searched the house and yard, there were no signs of anyone besides Dad. They also took away the golf club."

Mr. Lewy: "It wasn't just a golf club. It was a 3-wood. And I need it back before the tournament next week."

Son: "Dad, you aren't in a tournament next week."

Dr. Grumpy: "Okay, so..."

Son: "And it was a 9-iron, not a 3-wood."

Mr. Lewy: "I'm not that far gone. It was a 3-wood. Know your damn Callaways."

Dialing for dollars

Doing some marketing surveys for $ over the long holiday weekend.

They often include questions to see if you're paying attention, like this one:

Then there's this, asking me how many patients with a given condition I've seen in the last month:

The first choice (which I had to look up) is from a Roald Dahl book. It's a disease contracted by eating shoelaces that turns you into a rat. Although personally I think it would be much cooler if it turned you into a cassowary.

Then you get stuff that makes no sense whatsoever:

 

 

 

Or this one, which didn't give me any options in case this wasn't the case:

 

And lastly, in the middle of a survey on treatments for Alzheimer's disease, I encountered this question. I can only assume the survey writer had a personal interest in the topic.

Reality check

Yesterday I was on my way home from work when there was a loud noise and the Grumpymobile immediately veered right. I pulled into a side street to assess the damage:

 

Sigh.

So I dug out the spare and its gear and got started, jacking up the car, unbolting the shredded tire, tossing it in the trunk...

I'd just started rolling the spare around to the front when a crew from the Grumpyville fire department drove by. They pulled over and 4 guys piled out. One of them took the wrench out of my hand, another handed me a bottle of water. They bolted the spare on, lowered the car, and put all the stuff back in the trunk in what seemed like 15 seconds (maybe they were secretly an Indy pit crew).

As they piled back in their truck one of them said, "sir, it's pretty hot out, and a guy your age should know better than to do stuff like this."

Random pics

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

First, we have this, from a patient medication form:

 

I never thought of this product coming in different grades, and I really don't want to know what the difference is between "professional" and "amateur."

 

Next, in the way only Amazon can, we have this juxtaposition from their "you might also like" algorithm:

 

One reader is currently on an Alaskan cruise, and one night at dinner they were serving uh...

 

 

 

And lastly, the same reader saw this in a brochure on board. While I'm sure the award is well-deserved, I really don't want the details. I'm sure it involved being called at 2:00 a.m., was really disgusting, and had something to do with the all-you-can-eat buffet.

 

"Helluva diuresis, eh?"

One of my patients landed in the hospital overnight for mild pneumonia, and his wife asked me to look at the records to make sure there weren't any changes in his Parkinson's medications.

In the discharge summary I noticed this:

 

June 6, 1944

"There have only been a handful of days since the beginning of time on which the direction the world was taking has been changed in one 24-hour period by an act of man. June 6, 1944, was one of them.

"No one can tell the whole story of D-Day. Each of the 60,000 men who waded ashore that day knew a little part of the story too well. To them the landing looked like a catastrophe. Each knew a friend shot through the throat, shot through the knee. Each knew the first names of five hanging dead on the barbed wire offshore, three who lay unattended on the beach as the blood drained from the holes in their bodies. They knew whole tank crews who drowned when their tanks were unloaded in 20 feet of water.

"There were heroes here no one will ever know because they're dead. The heroism of others is known only to themselves.

"What the Americans and the British and the Canadians were trying to do was get back a whole continent that had been taken from its rightful owners. It was one of the most monumentally unselfish things one group of people ever did for another.

"It's hard for anyone who's been in a war to describe the terror of it to anyone who hasn't. How would anyone know that John Lacey died in that clump of weeds by the wagon path as he looked to his left towards Simpson and caught a bullet behind the ear? And if there had been a picture of it - and there weren't any - it would've shown that Lacey was the only one who carried apples for the guys in his raincoat pocket.

"If you think the world is rotten, go to the cemetery at Saint-Laurent-sur-Mer on the hill overlooking the beach. See what one group of men did for another, D-Day, June 6, 1944."

- Andrew Rooney (1919-2011)

I'm not following this

 Seen in a chart:

 

 

Quiz time

Okay, as required to maintain my hospital privileges (in addition to sending in a check) every 2 years I have to take mandatory online testing to make sure I can deal with situations at the hospital.

So, without further comment (that's your job, isn't it?) here are some of the questions I was asked, along with the answer options:

 

Here

LOOK, PEOPLE! JUST BECAUSE LADY GAGA IS ADVERTISING FOR A MEDICATION DOESN'T MEAN SHE'S GOING TO PAY FOR YOURS IF YOUR INSURANCE WON'T!

Waiting list

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

Ms. Frantic: "Hi! I really need to see a neurologist! All the ones at Massive Clinic are booked out to July, so I was hoping your office might have something sooner."

Mary: "Actually, you're in luck. We just had a cancellation for tomorrow, so Dr. Grumpy can see you at 10:00 in the morning if that works."

Ms. Frantic: "Dr. Grumpy has an opening for tomorrow?"

Mary: "Yes, would you like it?"

Ms. Frantic:" Um... no. Honestly, if your doctor isn't booked out, than he probably isn't very good. I'll just wait for July."

Detective stories

Did anyone else out there read "The Problem of Cell 13" by Jacques Futrelle?

I'm assuming I'm not the only one, as it was in the standard 6th-grade reading textbook my generic public school used in the early 1970's.

It was one of several early 1900's detective stories by Futrelle featuring his character Augustus S. F. X. Van Dusen (AKA The Thinking Machine), a reserved, brilliant, scientist who solved problems solely by logic (kind of a 1905 Mr. Spock). Almost 100 years later Van Dusen also appeared in the comic book series "The League of Extraordinary Gentlemen."

"The Problem of Cell 13" featured Van Dusen being voluntarily incarcerated in a high-security prison to prove that, by thinking, he could figure a way out and escape within a week - which he did. Probably Futrelle's most well-known story, it's since been adapted, both in whole and in part, several times for TV and radio. Most recently was in 2019 for an episode of the NBC TV series "The Blacklist."

For whatever reason it was a handful of stories I read growing up that I never forgot ("The Long Sheet" by William Sansom was another) and when the internet age dawned the story was long in the public domain and easy for me to find.

The writer, Jacques Futrelle started as a journalist. He began the sports section for the Atlanta Post, then was hired by the New York Herald where he covered the Spanish-American War. Afterwards he worked in Boston, then left journalism to become a full-time, and successful, detective writer.

His wife, Lily May Futrelle, was also a prominent author. She wrote for the Saturday Evening Post. Her first novel "The Secretary of Frivolous Affairs" was on the U.S. bestseller list from 1911 to 1915 and made into an early silent film (one of the first movies written by a woman).

Besides raising a son & daughter, and their separate writing careers, they collaborated on a Van Dusen story, "The Grinning God," in which she wrote the first half of the mystery to set the stage and he wrote the second half, with Van Dusen solving it.

They both did well as authors, allowing them to build a coastal home in Scituate, Massachusetts and enjoy the newfangled luxury of an automobile.

In early 1912 they left the kids with his parents and headed to Europe for 2-3 months to promote their books. The trip was successful, to the extent that they were given a complimentary first class suite by a shipping line for the journey home.

 

 

112 years ago tonight, the Futrelles stood together on the sloping decks of the Titanic.

Offered a chance to get in a lifeboat with her, he refused, and insisted the space be given to another woman.

After returning home, she wrote a 2-part piece on the disaster for the Boston Post, published on April 21-22:

 

"The last I saw of my husband he was standing beside Colonel Astor. He had a cigarette in his mouth. As I watched him, he lighted a match and held it in his cupped hands before his face. By its light I could see his eyes roam anxiously out over the water. Then he dropped his head toward his hands and lighted his cigarette. I saw Colonel Astor turn toward Jacques and a second later Jacques handed the colonel his cigarette box. The colonel screened Jacques' hands with his own, and their faces stood out together as the match flared at the cigarette tip. I know those hands never trembled. This was not an act of bravado. Both men must have realized that they must die."

 

His body was never recovered. He was 37.

Lily May never remarried. She raised their children, published her own novels, completed & published those Jacques hadn't, taught writing clinics, and hosted radio shows. In 1940 she spearheaded efforts to extend authors' copyrights for an additional 28 years, which was signed into law by President Roosevelt. She was given the pen that he used.

Every year, on the anniversary of the sinking, she walked from their home to the seafront to cast flowers in for Jacques.

She died in 1967.

Inside Job

A long time ago, when I was first starting out, I worked at a hospital that had only one MRI-compatible ventilator.

For my non-medical readers, a ventilator is the "breathing machine" that keeps you alive when your body needs a break, during surgery, etc.  Once you're better we take you off it. It's a very complicated gadget, with a fair amount of ferrous metal.

As a result, a standard ventilator can't go in an MRI. Since patients on one sometimes need an MRI (usually once a pesky neurologist gets involved) there are MRI-safe ventilators. These are stripped down machines, mostly plastic and non-ferrous metal. They're less durable than a regular ventilator and don't have all the features, but they're fine for an hour or so that a patient needs it while in the MRI machine.

Anyway, back at Small Hospital, one day the MRI-safe ventilator was missing. This was a real problem, because now we couldn't do MRI's on ICU patients who needed them. We were able to temporarily get an extra from a larger hospital across town, but still needed ours back. They ain't cheap.

Security searched, literally, every square inch of Small Hospital. The kitchens, the bathrooms, every patient room, the storage areas... it wasn't there. Small Hospital didn't have the array of video monitoring they do now, so looking for someone leaving with it wasn't possible.

One early morning during rounds I was in ICU, chatting about it with some of the nurses when one of them said, half-joking, "maybe it's on Ebay."

Since I was on the computer looking up labs, I switched over to Ebay... and there it was. A used MRI-compatible ventilator, same model, which had been up for sale since one day after it had gone missing. The seller's name was an easily-recognizable variant on the name of a guy who worked as a hospital radiology transporter.

The ventilator was back a few day later.

The transporter spent some time as a guest of the state, in spite of his clever defense that he'd seen it standing next to a dumpster at his apartment complex several miles from the hospital and had just kept it as a decoration because he didn't know what it was but it looked cool.

The machine was at the hospital for several more years before it was replaced by a newer model. For the rest of its service the nurses kept a sign on it that said "NOT FOR DECORATION."