Off, again

Heading out for our big trip of the summer.

3 kids, lots of relatives, and our credit cards.

See you in a few weeks!

Memories...

Back in residency, I occasionally had to round with Dr. Levodopa on weekends.

Dr. Levodopa, in a field of pathological personalities, had more odd mannerisms than I could count. But his strangest was that he carried a cup of black coffee... in his white coat pocket.

Not a travel mug, or even a generic cup with a plastic lid on it. But an open styrofoam cup. He'd fill it about 3/4 to the top at the nurses station, take a few sips, shove it in one of the coat's lower pockets, and start rounds.

So he had a large collection of white coats, all with dark coffee stains running from the right front pocket to the hem. As he'd walk, or move, or cough, coffee would slosh out, running down his white coat, pant leg, and to the floor. He never seemed to notice.

He was, though,  clearly aware of it, because he'd change into a clean coat as soon as he got to his clinic.

Like in "The Hitchhiker's Guide to the Galaxy," the resident on rounds with him would carry around a large towel (we kept several old ones in the call room for this purpose) to keep the floor from being slippery and wet as Dr. Levodopa wandered to and fro. He was, as best we could tell, completely oblivious to our efforts. Or, more likely, just didn't care.

25 years later... and I still don't understand why he did this.

Not particularly helpful

Seen in a chart. Apparently, death is a diagnosis, and it has a 100% chance of running in families.

Breaking news

Dr. Grumpy's crack team of reporters, bringing you the stories that shape your world.



Dateline: Shanghai, China. A flight from Shanghai to Guangzhou was delayed for 5 hours when an 80 year-old woman threw a handful of coins into one of the plane's engines. She apparently did this to ensure good luck on the flight.

A team of airplane mechanics had to disassemble and inspect the Airbus's engine to make sure none of the turbines were damaged and to remove all coins.

The total value of the coins involved was roughly 20 U.S. pennies.




Dateline: Tulsa, Oklahoma. A dead body was found inside a Walmart bathroom. It had apparently been there for 3 days.

A security camera recorded the 29-year-old woman entering the bathroom on Friday. At some point over the weekend an employee couldn't get the bathroom door open, and hung up an "Out of Order" sign. A repair crew found the body on Monday.

Police captain Todd Enzbrenner commented "It’s not every day you find this sort of thing in a business."




Dateline: Allyn, Washington. A man found a dead roadkill raccoon on the road, and decided to use it as bait to catch crabs. Like most dead things, it smelled awful, so he tied a rope to it to drag it about 15 feet behind him as he walked home.

Two drivers pulled over and confronted him, believing he was dragging a dead dog down the street. One of them shot the raccoon-dragging guy in the leg and drove away. He is expected to recover (the guy, not the raccoon). Police are searching for suspects.

Sheriff's department Lt. Travis Adams told reporters "I've been doing this for 21-plus years, and I've never quite heard the 'raccoon being dragged down the road' story before, so it's a new one for all of us."




Dateline: Modesto, California. A 45 year man was arrested for starting a fire in a Walgreen's bathroom.

The man told police that he'd had "an accident," and soiled his underwear. He went into the bathroom to take them off and, for unclear reasons, felt the best way to do so was to light them on fire - while still in them.

This got the underwear off, and the man tossed them in the toilet to extinguish the blaze. While no damage was done to the store (or, amazingly, him), this set off the fire alarm and they had to evacuate the building.

Bow wow wow yippie yo yippie yay

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

Mrs. Woof: "I need to get into Dr. Grumpy right away! I was bitten by a dog, and may have suffered nerve damage!"

Mary: "Okay, we don't have anything until next week, are..."

Mrs. Woof: "But this needs to be done urgently. I think I need stitches!"

Mary: "Um, when did this occur?'

Mrs. Woof: "Five, maybe ten minutes ago. It's bleeding all over the place!"

Mary: "You need to go to ER. Dr. Grumpy doesn't handle injuries like this."

Mrs. Woof: "But there might be nerve damage! He's a nerve doctor!"

Mary: "Yes, but he's not going to put stitches in it, or know what else to do. You need to go to ER, and let them see what's going on."

Mrs. Woof: "You people are a waste of time!"

(click)

Don't piss him off

Seen in a chart:

"Well, that's not so big, works out to only 563 meters."

Projection

Mrs. Pesce: "That's not the same fish you had at my last visit, is it? I thought it was a different color."

Dr. Grumpy: "Yeah. It's a new fish. Ed, uh, retired.”

Mrs. Pesce : "So what's this one's name?"

Dr. Grumpy: "Ed. I name them all Ed. Makes life easier."

Mrs. Pesce: "You know, I didn't like the last fish. Every time I came in he looked at me, really angry. Like he thought I was faking everything. I hate to say it, but I'm glad he's dead, because I'd been thinking about changing neurologists because of him and his attitude."

No shit, Sherlock

These are the kinds of warnings that modern, technologically advanced, highly sophisticated computer prescribing systems give us dumb ol' doctors when we're trying to refill your medication. Because even if we're just refilling it, the computer wants us to know that IT'S DANGEROUS TO DO SO because apparently you're already on it (which is the whole point of a refill, isn't it?).

And what's with the weird capital / lower case scheme on some of these?

Breaking news

Dr. Grumpy's crack team of reporters continue to bring you the stories that shape your world.

The summer amusement park season is upon us, and unfortunately tragedy has already struck at America's most legendary one.

This past Friday night 17 people, including 6 innocent children, were enjoying an up-till-then fun day at Disneyland. They were standing near Sleeping Beauty's castle when they were horrifically splattered with a large volume of bird poop from a passing flock of geese.

An unidentified bystander, who apparently doesn't know shit, called 911 to report that someone was throwing human turds at people.

This resulted in a city HazMat team being dispatched to the scene, hopefully in those bright yellow suits so people would think they were re-enacting a child alert from Monsters, Inc.

The crappy situation was resolved by taking the victims to a "private restroom" (what does that mean, anyway? No one has used it since Walt died, like the room over the fire station?). There they were provided with clean clothes ("Birds shit on me at Disneyland and all I got was this crappy T-shirt").

At press time the geese were unavailable for comment.

Research

Dr. Grumpy is no stranger to not-particularly-worthwhile research, having published some myself.

I get it. You didn't want to do it, but you're in training, and your chairman made you write up something embarrassingly bad in order to graduate. BTDT.

Last week, some of the biggest names in Parkinson's disease (besides James Parkinson) gathered in Vancouver, BC, for a conference.

One of my colleagues there noticed this poster hanging in the meeting's research hall:

To summarize:

Earthquakes are bad. Having Parkinson's disease, AND being in an earthquake, is worse.

The bigger the earthquake, the greater the effect will be on a Parkinson's patient.

Their symptoms will get worse in the immediate aftermath of the quake, but gradually return to baseline as things settle down.

Thank you, SMOD!

Holiday road

All right, with the kids' band stuff, school getting out next week, the kids' band stuff, visiting relatives who have given us short notice, all sorts of school-year-end craziness, and the kids' band stuff, I'm going to have to take 2 weeks off from the blog to deal with the insanity.

And I need to pick up beer.

Lots of beer.

See you in 2 weeks!

Friday reruns

One of my all-time favorite chart excerpts:

Calls

Ms. Auth: "Major Illness Insurance."

Dr. Grumpy: "This is Dr. Grumpy. I'm calling to get a medication authorized on a patient."

Ms. Auth: "Okay, what is their 10 digit ID number"

Dr. Grumpy: "It's... The only number on her card is 7-digits, 8675309."

Ms. Auth: "No, I need the 10 digit one"

Dr. Grumpy: "There isn't another number on here."

Ms. Auth: "Well, I can only work with the 10 digit one."

Dr. Grumpy: "What about her name and birthday? Or Social Security number?"

Ms. Auth: "We don't use those. The only thing I can work with is her 10 digit number."

Dr. Grumpy: "How do I get that?"

Ms. Auth: "Call back and press option 5. Then enter her 10 digit number in order to get it."

Dr. Grumpy: "But I don't have the 10 digit number!"

Ms. Auth: "Then we can't help you, can we? Have a nice day."

Stress

Dr. Grumpy: "That's odd for you to have a seizure. Did you miss a medication dose?"

Ms. Rummage: "Yeah... Actually I haven't taken it for almost a week."

Dr. Grumpy: "Did you run out?"

Ms. Rummage: "No, I've just been really stressed out over having a garage sale."

May 20, 1937

80 years ago tomorrow, one of the finest moments in BBC history occurred.

Lt.-Cmdr. Thomas Woodrooffe was a retired Royal Navy office who covered the navy for BBC news. He’d previously served on the battleship HMS Nelson.

In 1937 the fleet held a large review at Spithead, which included the visiting battleship USS New York. The plan was for him to broadcast that evening from aboard HMS Nelson, when all the ships would have lights strung in their rigging.

Unfortunately, after he boarded Nelson he ran into many of his old shipmates, and they decided to have a drink... then another... then a few more... With the end result being that when Woodrooffe took the microphone that night he was completely smashed drunk.

To the horror of his bosses, his live BBC news broadcast consisted of his slurred, inebriated voice, repeatedly saying the fleet was “all lit up, like fairyland” (obviously, the fleet wasn't the only thing lit up) and rambling into the microphone. In that era the technology to cut him off and switch to something else wasn’t readily available, so he was able to go on for several minutes before they finally pulled the plug.

For those who want to listen, this is the actual recording.

If you want to read it, here's a transcript:


ANNOUNCER'S INTRODUCTION:

This is the Regional Program. The Illumination of the Fleet. Once again, we're taking you on board HMS Nelson for a description of the scene at Spithead tonight by Lieutenant-Commander Thomas Woodrooffe.

LIEUTENANT-COMMANDER WOODROOFFE:

"At the present moment, the whole fleet is lit up. When I say 'lit up', I mean lit up by fairy lamps.

"We've forgotten the whole Royal Review... we've forgotten the Royal Review... the whole thing is lit up by fairy lamps. It's fantastic, it isn't the fleet at all. It's just... it's fairyland, the whole fleet is in fairyland.

"Now, if you'll follow me through... if you don't mind... the next few moments... you'll find the fleet doing odd things. At the present moment, the New York, obviously, is lit up ... and when I say the fleet is lit up ... in lamps... I mean, she's outlined. The whole ship's outlined. In little lamps.

"I'm sorry, I was telling some people to shut up talking.

"Umm... what I mean is this. The whole fleet is lit up. In fairy lamps, and... each ship is outlined.

"Now, as far as I can see is about... I suppose I can see down about five or six miles ... ships are all lit up.

"They're outlined, the whole lot. Even destroyers are outlined. In the old days, you know, destroyers used to be outlined by a little kind of pyramid of lights. And nowadays... destroyers are lit up by... they outline themselves.

"In a second or two, we're going to fire rockets, um, we're going to fire all sorts of things, and... you can't possibly see them, but you'll hear them going off, and you may hear my reaction when I see them go off. Because, uh, I'm going to try and tell you what they look like as they go off. But at the moment there's a whole huge fleet here. The thing we saw this afternoon, this colossal fleet, lit up... by lights... and the whole fleet is in fairyland! It isn't true, it isn't here!

"And as I say it ...

"It's gone! It's gone! There's no fleet! It's, uh, it's disappeared! No magician who ever could have waved his wand could have waved it with more acumen than he has now at the present moment. The fleet's gone. It's disappeared.

"I'm trying to give you, ladies and gentlemen... the fleet's gone. It's disappeared. I was talking to you... in the middle of this damn (cough), in the middle of this fleet... and what's happened is the fleet's gone, disappeared and gone. We had a hundred, two hundred warships around us a second ago, and now they've gone, at a signal by the Morse code, at a signal by the fleet flagship which I'm in now, they've gone, they've disappeared.

"There's nothing between us and heaven. There's nothing at all."

Wednesday reruns

Last night I was at a dinner meeting for a research company. These things are always held at some swanky overpriced steakhouse.

Dr. Duffel is a local neurologist who drags around the biggest damn purse in the world. It's HUGE, and goes everywhere with her. For years many of us have wondered what's in it: a complete set of every neurology journal ever written? Jimmy Hoffa? an iPhone 87s+?

So last night she came in late to the dinner, and sat down next to me. She put el monstro humungo purse on the floor next to me, so I had to move over a bit.

The meeting dragged on. One slide after another. The occasional cell phone ringing. The speaker droning. Food courses.

At some point I wandered out to stretch and empty myself of biologically-filtered Diet Coke. When I came back and sat down I stepped in a puddle on the floor. I figured someone must have spilled water or something while I was out of the room, and refocused my attention on the speaker.

A minute later a waitress came by to refill my Diet Coke, and stumbled over the giant purse.

And the purse started barking.

The waitress screamed and leaped back, dropping the pitcher on the purse, which only got it snarling at her.

Dr. Duffel jumped up, grabbed her cell phone (which hadn't rung), mumbled "I have to answer this outside" and dragged her growling purse out of the room. I'm pretty sure it wasn't her ringtone.

She never came back.

I rinsed off my shoes when I got home.

Sunday night

It's 11:18 p.m. I'm fast asleep, and my phone rings.

Dr. Grumpy: "Hello?"

Dr. Brain: "Hi, Ibee? It's me."

Dr. Grumpy: "What's up?"

Dr. Brain: "I couldn't sleep, so I'm reading the new issue of 'Journal of Obscure Neurological Diseases of Burkina Faso.' Have you looked at this months?"
 
Dr. Grumpy: "Uh, it's 11:30 at night and I was..."

Dr. Brain: "They're COMPLETELY changing the diagnostic criteria for Fleaglehart's Syndrome! I disagree with the entire thing. I mean, now they're considering visual changes to be helpful, but not diagnostic, of the disorder. They're increasing the importance of mental status changes, and now there are more than the 2-3 standard MRI findings we're used to."

Dr. Grumpy: "Uh..."

Dr. Brain: "This is RIDICULOUS! I mean, how many cases of Fleaglehart's Syndrome have you seen that would fit this new criteria?"

Dr. Grumpy: "Look. It's 11:30 at night, you woke me up, and honestly I've never seen a case of it."

Dr. Brain. "Really? Neither have I. Okay. Have a good night."

The visitor

I'm in my office looking through MRI reports.


Mary: "Hey doc, there's a drug rep up front, says he needs to talk to you. Says it's not a sales call."

Dr. Grumpy: "Okay, just send him back."

(drug rep comes in)

Dr. Grumpy: "Hi, Matt. What's up?"

Drug rep Matt: "Sorry to bother you, but I was told to come talk to you about a weird request my company got."

Dr. Grumpy: "About..."

Drug rep Matt: "A patient of yours called my company, and said you'd authorize her to get 4 replacement injector pens and we just had to contact your office. I thought I'd come by myself, since we hadn't heard anything about this from you guys."

Dr. Grumpy: "Did you hear what happened to the pens?"

Drug rep Matt: "That's the weird part. She contacted 3 service reps, told one the pens were stolen, another that they were never delivered, and another that her boyfriend backed over them with his car."

Long pause

Dr. Grumpy: "Actually, she and some friends got drunk and then tried using them to pierce their ears."

Long pause 2 

Drug rep Matt: "Are you shittin' me?"

Dr. Grumpy: "Nope."

Drug rep Matt: "I'm going to assume your story is the correct one?"

Dr. Grumpy: "That's the one she called me with Saturday morning."

Drug rep Matt: "I'm pretty sure we don't have a program to replace pens lost through, um, misadventure."

Dr. Grumpy: "Believe me. I understand. We've been dealing with her all week."

Long pause 3.

Drug rep Matt: "Thanks. I'll let you go. Wow. This sounds like something you'd read on a med-blog."

Annie's desk

Ms. Myelin: "Hello?"

Annie: "Hi, this is Annie, at Dr. Grumpy's office."

Ms. Myelin: "Oh, good. Did you order my new MS pens?"

Annie: "No, I just got off the phone with your insurance, and they won't replace pens that are damaged that way."

Ms. Myelin: "That's what they told me, too!"

Annie: "You called them yourself?"

Ms. Myelin: "Yes, I figured you'd just ignore me. Do you have any idea how long they made me sit on hold?"

Annie: "Um, yeah."

Ms. Myelin: "This is ridiculous. I need this medication, and my insurance company won't give it to me, even though it's been authorized and I've paid all my premiums."

Annie: "Well, you get a limited number of pens a year, and that's what they've given you. You broke 4 of them using them for something they weren't designed for."

Ms. Myelin: "Like it's my fault they put such a cheapshit needle on that it broke."

 Annie: "I..."

Ms. Myelin: "Can't you tell them that they were defective? Or that I broke them defending myself from a burglar or something?"

Annie: "I need to point out here that you called them before me, and told them the real story."

Ms. Myelin: "I didn't think they'd be such uncaring assholes. Whatever happened to 'honesty is the best policy'? I'm pretty sure the insurance phone bitch was laughing at me."

Annie: "Well, at this point the only way you can get them replaced is to pay cash."

Ms. Myelin: "WHAT? Do you have any idea how much this costs? It's $1200 for each of their crappy pens."

Annie: "There's really nothing else I can do"

Ms. Myelin: "Can Dr. Grumpy pay for them? He's the one who prescribed it, after all. I just took his advice."

Annie: "No. Maybe you should ask Ashley and Amy for help?"

Ms. Myelin: "I'd never ask my friends to do that for me."

Saturday

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

Ms. Myelin: "Hi, I see you for Multiple Sclerosis, and I'm on that drug you inject with a special pen?"

Dr. Grumpy: "Yes?"

Ms. Myelin: "I need to get 4 new pens ordered for the month. The ones I have are all broken, so I'm going to run out."

Dr. Grumpy: "A month's worth of injector pens were all broken?"

Ms. Myelin: "No. I mean yes. I mean, they are now."

Dr. Grumpy: "Did they get shipped to you broken?"

Ms. Myelin: "I don't think so."

Dr. Grumpy: "So how are they all broken?"

Ms. Myelin: "Well, for Cinco de Mayo me and my girlfriends were at the Smashed Iguana. They were having tequila shot specials, and they do that thing where they pour margaritas right in your mouth? Anyway, we came back to my place to crash, and while we were sitting around Ashley said she'd been meaning to get her ears pierced in new places. Amy volunteered, cause she once did her own when she was in high school and said she'd been meaning to do the same. But I didn't have anything that would really work, then remembered I had my MS drug injector pens and they have pretty sharp needles, so we..."

Dr. Grumpy: "You used MS injector pens to pierce your ears?"

Ms. Myelin: "Well, yes. I mean, on a Friday night at 11:30 it's not like the place at the mall was open."

Dr. Grumpy: "I'll talk to Annie and get back to you on Monday."

Friday reruns

Dr. Grumpy: "So at what point did you call 911?"

Mr. Young: "When I realized she was having a seizure."

Dr. Grumpy: "How long after the seizure started was that?"

Mr. Young: (looks at Mrs. Young, both blush, look at floor) "Well, I didn't call right away, because we were, um, having sex at the time, and when she started shaking I just thought she..."

Dr. Grumpy: "Got it. So how long did the seizure last?"

Losses

Mary: "Let me give you these forms... Here's a pen... can I get a copy of your insurance card?"

Mrs. Card: "No."

Mary: "Do you have it with you?"

Mrs. Card: "Yes, but I don't know Dr. Grumpy yet. Can I give it to you after the visit, if I think he deserves to get paid?"