And now, music

Seen in a chart

This isn't the first time I've put up stuff like this, and it won't be the last.

But you know what? Crap like this is no longer the exception. It's the rule. I'd say at least 50%-60% of charts I read from hospitals and practices that use computer charting systems (which is pretty much all of them) have errors of this kind.

And these are what the world is pushing us to use more and more of.

I'm not saying computer chart systems are bad things. They have a lot of advantages. But they also encourage the slacker inherent in all of us. It's easier and faster to check boxes, cut & paste, and use templates than it is to actually type out what's correct. Especially if you skip the critical step of proofreading what you've just done. Most do.

The majority of these errors are just amusing. This one is just stupid, but likely won't cause a serious patient outcome.

But if it can make an error about smoking, it can also make them about your allergies. Your current medications. What conditions you have. Your past surgeries.

And one "minor" error in any of those could lead to a disaster in the right setting.

Cole slaw

I'm in the emergency room, talking to a patient's wife:



Dr. Grumpy: "When did this all start?"

Mrs. Concern: "Last night. He fell down in the bathroom, and said he couldn't move that side."

Dr. Grumpy: "Then what happened?"

Mrs. Concern: "I figured he was just angry at me, and trying to get attention. We'd had this big argument over cole slaw at lunch, because..."

Dr. Grumpy: "Okay, but last night..."

Mrs. Concern: "Oh yeah, anyway, so I watched some TV in bed - there's that new detective show I like - until I fell asleep. When I woke up this morning he was still on the bathroom floor, and boy, was he angry. So that was when I called paramedics."

New year's day

10 years

This post wraps up 2018. I'll be taking 3 weeks off, and will see you guys in January.


December 21, 2008, was, apparently, a slow news day. In looking backwards I really can't find any articles of note from the major news outlets on that date's happenings.

But to me it was a big day as I published my first post here.

A lot of factors had led up to it. For years I'd been collecting stories hoping to write a book... someday. But life, work, and kids get in the way of those things. At some point I realized the book was never going to happen.

Then, in 2008, a change in my practice led to me having a bit more free time. So, instead of a book, I decided to share my stories on this blog.

And here I am, 10 years out. My numbers have gone up and down, but I still seem to have a following. For that I'm grateful. If it wasn't for you guys there wouldn't be a reason to do this. My posts have dropped from twice daily to 2-3/week, but I'm still cranking them out and hopefully will continue to do so.

I appreciate those of you who have stayed with me and written comments. I've only been mentioned once in the general media, but knowing you guys are reading makes it worthwhile to keep doing this.

At 10 years out I want to thank my wife, for putting up with me, and my kids, who've grown from small rug rats to young adults heading for college since I started this.

I also want to thank Mary and Annie, also for putting up with me and supplying me with stories to share. Without you guys I wouldn't have a real job.

My patients deserve a big round of applause. Without them I wouldn't have this blog. Most of them are good folks, and I genuinely appreciate them making my job a fulfilling one. Medical blogs may give you the impression that most patients are insane, or stupid, or both, but that's far from true. The vast majority are good people, but stories of normal patient encounters are boring and aren't why you come here.

Lastly, I want to thank all of you guys for sticking with me over time, sharing your thoughts, and making this fun.

A special thank you is deserved by those I've met through the blog and who I'm now proud to call friends. We may never meet in person, but knowing you're out there is good enough for me.

Thank you all, have a great holiday, and I'll be back on January 14, 2019.

IG

2018 Holiday gift guide

Do you have a friend who's a dentist? Do you want to give your dentist something more meaningful than the gouges you leave on the arms of his exam chair? Do you know someone who simply has no sense of taste (me, for example)?

Then consider this cozy pair of pants:

Featuring an attractive pattern of molars and bicuspids in alternating red and white (I guess the color depends on whether you remembered to stop taking warfarin before your root canal), these pants are ideal for visits to the dentist, holiday parties, and any job you're hoping to get fired from.

2018 Holiday gift guide

Those old enough will remember Rockwell's 1980's hit "Some Random Guy is Watching Me."

Wait? That wasn't the title? Never mind.

But if you have a friend who has delusions of that sort, you can order this for them:

The "Old Asian Man Wall Decal" (seriously, that's what it's called) is available from a number of websites for people wanting to add it to their home's atmosphere. Or something.

2018 Holiday gift guide

Do you have a friend who's trying to attract the perfect guy, hoping her perfume will do the trick?

Maybe you should get her this:

Let's face it, nothing gets a guy's attention like a woman who smells like a slab of roast beef. Or an Arby's.

If nothing else, she'll certainly have the attention of every dog in the neighborhood.

Saturday morning

Frank got home from his first college semester last night.

This morning, Mrs. Grumpy and I were woken from a sound sleep by screaming and loud noises.

Apparently, at around midnight, Frank couldn't sleep and set up his laptop to work. He'd forgotten the password for our home WiFi network. Instead of, say, waiting to ask someone in the morning, he just wiped the router and changed the passwords.

This morning the twins discovered what had happened, and went bananas when they couldn't get online. His door was locked, and when they couldn't wake him up, Marie and Craig kicked his door in.

Now Frank is upset we woke him up on his first day of break.

I'm taking the twins' side.

2018 Holiday gift guide

Do you have a friend who thinks he has animal magnetism? Maybe these boxers are the perfect gift:

Available from Newchic, this pair of boxers has a series of magnets sewn into the vital package-support area. The website makes claims about this boosting the immune system (it doesn't say if they specifically mean against STD's), "releasing energy," (if my winkie was glowing that color, I'd be pretty worried about the energy source) and (my favorite) improving the body's oxygen supply.

Plenty of guys, myself included, have been accused of thinking with our male appendages. To date, however, I've never been accused of breathing through it.

Isn't that right, Mr. Snuffleupagus?

2018 Holiday gift guide

Mattel, the company that brought you Barbie, Hot Wheels, Masters of the Universe, American Girl, Polly Pocket, and Matchbox, now brings you its next big seller.

And... I'm going to have to let these ladies describe it, because I couldn't possibly do a better job.

Please note, this is not a joke.

2018 Holiday gift guide

Like most medical students, you're tired. You just finished class and want to crash out on the couch. But you've also got a big test tomorrow and need to study. What can you do? Hey, I've been there myself.

You can hit the textbooks, or you can study planted on the couch if you have this human anatomy throw pillow!

What better way to get some studying done, or liven up a dinner party, than with this useful pillow cover? (Sorry, folks, the pillow isn't included).

To quote from the product description:


"Makeover and refresh your rooms with just a single touch!"

"Perfect for your home, office, playroom, kids room, cafe, study, studio, club, bar and others."

"No dye substance harming the health of you and your family."

"A perfect gift idea for your mom, dad, sister, brother, grandma, wife, husband and all other beloved ones."

"They will be shocked by the superior quality of the item when they open the present."

"We follow current trends and bring you the latest home fashion."

"A gift to your family or friend, relative or boyfriend girlfriend, or to yourself, the item should be interesting and authentic."


It most certainly is.

2018 Holiday gift guide

Do you have a friend who needs some absolutely pointless piece of furniture? Do you have an extra $12,000 you'd like to blow?

Then this is perfect!

Why have a routine sofa that takes up horizontal floor space, when this one stands vertically?

Yes, you could take the regular sofa you already have and stand it on it's side, but what's the point? This one already does that!  Instead of getting some piece of schlock that does nothing but let people sit on it, you can have one that serves absolutely no purpose other than to say you can afford it! And isn't that what home decorating is all about?

Joe and Al

Joe and Al are both patients of mine.

They don't know each other.

They were born in the same year, a few thousand mild miles apart, speaking different languages.

To most who meet them they come across as polite older gentlemen, each with a good sense of humor. They may notice Joe's tremor or Al's speech difficulties, but neither is a major part of who they are.

But to me, they mean a lot after 20 years in practice.

Joe was born in Poland. His father was a tailor, and Joe worked in the store growing up. Because they were Jews, the family business was closed by the government so they had no way to support themselves. He saw his father beaten to death for trying to keep the family together while boarding a train. His mother was put in a different train car and never seen again. His sister was forced to work in a brothel for German officers and was never seen outside that building again. He and his brother were together until they got to the camp sorting area. His brother, who had a bad cough that week, was sent to a gas chamber. Joe was sent to do slave labor, and was still alive when the camp was liberated by allied forces. Joe, at 5'10" weighed 94 pounds by that point, and was hard to distinguish from the dead bodies he'd been forced to carry outside.

After recovering in a military hospital, Joe decided to leave Europe forever. He immigrated to America, settling in Omaha. He went to school, married, raised a family, and spent most of his life in a quiet, unassuming, desk job. Today he's nearly blind and needs a walker to get around. His wife is still at his side, and sometimes one of his kids.

Al was born in Los Angeles. He worked in a grocery store and went to high school until he turned 18, when he was drafted into the Marines.

On the morning of February 19, 1945, he was roughly 6,000 miles from L.A., in landing crafts with 60,000 other Marines, approaching the peaceful-appearing sands of Iwo Jima in the south Pacific. As they clambered ashore and gradually moved inland it was surprisingly quiet, with none of the resistance they'd encountered on previous islands.

About an hour after coming ashore, that all changed. The well-hidden Japanese forces opened up on the beach with machine guns and heavy artillery, creating a hell-on-earth. There was nowhere to hide. Al saw guys he'd had steak & eggs with a few hours earlier (the standard U.S. Marine breakfast for landing forces) collapse around him, dead. Some were wounded, and he and others tried to get them to whatever safety they could find. Then he was hit himself, but worked to help others until he blacked-out from blood loss. He woke up on a hospital ship.

After the war he returned home, finished school, and managed grocery stores until he retired. He and his wife raised a boy and 2 girls. They recently celebrated their 60th anniversary. Today he uses a walker and oxygen tank, and is nearly deaf, but still has a hearty laugh.

At this point both are in their 90's. The horrors they experienced aren't forgotten, but hidden behind a lifetime of mundanity (which, lets face it, mundanity describes most of us, and it isn't a bad thing).

In my mind they're bound together by being (most likely) the last of their kind I'll meet.

I've seen my share of Holocaust survivors, but as the years go by they've decreased, and I doubt I'll meet another after Joe.

Similarly, in 20 years I've cared for plenty of WW2 veterans, but see them grow fewer, and the odds are I won't meet another who fought at Iwo Jima.

Like many of their generation, neither wants to talk about what they went through. The memories are painful, and both men would rather be defined but what came afterwards: their families.

But they, and what they went through, shouldn't be forgotten.

Ever.

2018 Holiday gift guide

How many times have you gotten home from a long day at work, opened a cold beer, and thought, "Boy, I'm tired. I'd love to relax by putting my head in someone's ass crack."

Me neither.

Butt, if you have any friends who think this way, now there's the perfect pillow to give them!

Yes, you can relax by lying down with your head on a simulated keister. If people are always telling you that you have your head up your ass, you can now respond, "no, that's my pillow."

The website says they're "squeezable, slappable and face buriable" for those who consider these to be desirable features in tuchus-shaped bed accessories. It also notes "you can dress up your Buttress with undies and PJ's," provided you're into that sort of thing.

I understand that Mr. Arthur Frampton is coming out with a deluxe version.

2018 Holiday gift guide

Yes, as the Earth rolls around its G-type main-sequence star, we again come to the Christmakuh season. Which means it's time for DR. GRUMPY'S ANNUAL GIFT GUIDE!

This year, I'd like to start off with something for that distant acquaintance, co-worker, or friend who feels they have to hold the first party of the season, even if that means having it in July just to say they did.

What's more perfect for your friend's next party than this adorable snowman beverage dispenser?

They'll marvel when you give them this cheerful fellow to dispense refreshments from a, um, conveniently located valve. See him smile as you pull down, squeeze, and release.

Serving suggestions include spiked lemonade or Mountain Dew, though if you're a urologist you could also consider something with cranberry juice or grenadine syrup added for just the right tint.

Thanksgiving memory re-runs

One Thanksgiving in the early-90's I was the intern on call at a local VA hospital (a veterans hospital for my non-U.S. readers, with consequently a primarily cantankerous elderly male population).

A peculiar thing about VA hospitals (at least back then, I haven't worked at one for > 25 years) is that patients could sign out at the nurse's desk to leave, then come back later to resume medical care (don't even try to understand this). So the sheet was always full of notations that patients had signed out to go to McDonald's, or buy cigarettes, or smoke, or visit friends at the homeless shelter, or hold up a liquor store, or whatever.

Some bright businessman had opened a strip club across the street from the hospital, I think it was called The Jaguar Room. So on Thanksgiving the VA ward I was covering was empty, as most of the patients had signed out to walk, wheel, or crawl over to The Jaguar Room for some female comfort and booze.

I was asleep in the intern's room when the calls began coming in, all from the bartender at The Jaguar Room. Was it safe for my patients to be smoking through their tracheostomy tubes? Were the cardiac telemetry packs still transmitting from across the street? Was there a place at the VA where patients could get more $1 bills, because they'd used them all up on the strippers?

And my favorite:


Bartender: "Can I give Mr. Veteran another beer?"

Intern Grumpy: "Um, what's the problem?"

Bartender: "He has one of those foley bags things, with the tube going up his dick. The bag is, like, REALLY full, and I'm afraid if I give him another beer it'll pop and send piss everywhere."

Intern Grumpy: "Send him back to the hospital."

Bartender: "That's bad for business."

Intern Grumpy: "So is showering your clientele with piss."


Mr. Veteran was wheeled back over to the VA immediately, by a topless stripper no less, who waited while his bag was emptied and then pushed him back to the bar.

Ebay has everything

During her appointment I was helping Mrs. Old find a better price on her pain medicine, which (of course), activated the ad-tracker software.

So a few minutes later I noticed this on a site:

Who are the people in your neighborhood?

Dr. Grumpy: "At your last visit... let me look at the note... okay, you said you wanted to see if a massage helped your back pain, and were going to try a place near your apartment. So how'd that work?"

Ms. Lumbago: "It, um, didn't happen."

Dr. Grumpy: "Too expensive?"

Ms. Lumbago: "No... I went in there one day, and said I needed a massage, and the girl at the counter gave me a blank look. Then I realized all the girls there were in skimpy bikinis, and they had candles and soft music and a bottle of champagne out, and the counter girl said, um, 'we only take men customers' and I realized that, um... anyway I left and haven't had time to look for another place."

Seen in a chart

Knowns and unknowns, both unknown and known.

- Thank you, C!

Chutzpah

It's 10:55. Mrs. 11:30 walks into the waiting room, where Mr. 11:00 is reading a magazine.


Mary: "Hi, can I help you?"

Mrs. 11:30: "Yes, I have a routine appointment with Dr. Grumpy at 11:30, but my husband has a work-in with his cardiologist downstairs at 11:45, which he just made. Can I be seen early, so I can run down there?"

Mary: "I'm sorry, he's with someone now, and has an 11:00 appointment ahead of you. Otherwise I would."

Mrs: 11:30: "Can you..."

Mr. 11:00: "Hi, I don't mind waiting. I have the 11:00 appointment, so why don't you just switch us out? I don't have to be anywhere right away."

Mrs. 11:30: "Oh, thank you so much."

Mary: "Okay, that works for me. I'll let the doc know you're switching."


I finish with Mr. 10:30 and bring him up to check-out. Mary quickly explains the schedule change, so I bring Mrs. 11:30 back to my office. I address her issues, and we conclude the visit at around 11:25.


Dr. Grumpy: "All right, let me know how the medication change works out... I hope everything is okay with your husband."

Mrs. 11:30: "My husband? Why?"

Dr. Grumpy: "You said he had an urgent work-in with his cardiologist?"

Mrs. 11:30: "Oh, I just told the front people that. He's fine. I just needed to leave early because my cat sitter can't stay past 11:45."

She walked out front and left.

Texting with Frank

Also, stop calling me "Bro."

Seen in a chart

For my non-medical readers, the last word is supposed to be "hematuria."

Annie's desk

Annie: "Dr. Grumpy's office. This is Annie."

Mrs. Daughter: "Hi, Dr. Grumpy saw my mother last week, for Alzheimer's disease. We're trying to get her long-term care approved, and need him to fill out the forms. I forget to ask him when we were there. Can I drop them by the office later today?"

Annie: "Certainly, but he's out of town this week, so won't be able to do them until he's back. We can mail or fax them back to you when ready, or you can come get them."

Mrs. Daughter: "What do you mean 'he's out of town?' "

Annie: "Family vacation stuff, his kids are off for fall break, so..."

Mrs. Daughter: "That's ridiculous. I want these forms done NOW."

Annie: "Well, he'll be back next week, so will be glad to do them then, or you can see if your mother's internist can..."

Mrs. Daughter: "The internist is the one who referred me to you. Obviously, I wouldn't have come to you if I'd known he was THAT kind of doctor!"

Annie: "Um, what kind of doctor?"

Mrs. Daughter "The kind who takes vacations when his patients need him!"

Time out

All right, gang. I'm going to have to take a few weeks off here. We're now entering the heart of the high school marching band competition season, and between my day job and band meetings, band fundraisers, band shows, band-aids, band trips, rubber bands, and band saws I need to take some time off from the blog (and a lot of other stuff, too).

See you in a few weeks!

Breaking news!

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


DATELINE: SANTA MARTA, COLUMBIA.

Yeimy, a married woman, and Jesus, who she'd been having a clandestine year-long affair with, decided to call Uber for a ride to a local motel they'd booked for a romantic 30 minute getaway. The helpful Uber app noted that their driver was on his way to transport them to the love nest.

Upon arriving, they piled into the back seat of his car, only to have all parties immediately realize that the driver was actually Yeimy's husband, Leonardo, who was moonlighting that night by driving for a friend.

All parties immediately exited the vehicle.

It's unknown how many stars the driver got.



DATELINE: CALIFORNIA

A group of thieves stole $18,000 worth of industrial-use GPS tracking devices from a tech company.

Upon discovering the loss, the company remotely switched them on and saw the majority of the devices were in a warehouse, while 2 were still being driving around in cars. Police had arrested all involved and recovered the devices within 6 hours.

Police also noted the thieves had drunk a few beers they'd found during the robbery. One of them cut himself in process, leaving bloody fingerprints behind as additional evidence.



DATELINE: FRANCE

From the "A horse walks into a bar" department.