For those who didn't see it

Toxic

Phone rings.

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

Mrs. Latrodectus: "Hello, I need to make an appointment with Dr. Grumpy."

Mary: "Let me put you on hold for a sec, I'm scheduling another patient right now."


Mary finishes scheduling the other patient in < 1 minute, goes back to Mrs. Lactrodectus, finds she hung up.

Phone rings.


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

Mrs. Latrodectus: "How DARE you put me on hold. I'm a VERY busy woman!"

Mary: "Sorry, but there's always a lot going on here. Okay... We have an opening next Wednesday afternoon... what are you going to be seeing Dr. Grumpy for?"

Mrs. Latrodectus: "Excuse me? Are you the doctor?"

Mary: "No, I'm his secretary."

Mrs. Latrodectus: "Well, I don't have to tell underlings why I'm coming in. Unless he's willing to get on the phone right now, I have no plans to discuss this on this call."

Mary: "The only reason I ask is because there are several disorders he doesn't handle, and so I don't want to waste your time, or his, if you come in and he doesn't see your condition."

Mrs. Latrodectus: "I'm a very busy woman and don't have time for this nonsense. Why don't you just tell me all the things he doesn't treat and I'll decide if this is worthwhile."

Mary: "I'm not going to do that. Do you want to make an appointment or not?"

Mrs. Lactrodectus: "You have some nerve!"

Click.

Seen in a chart

Day at the Races

Early last Friday morning Mr. Party, a heavy-drinking patient of Dr. Smith (an internist downstairs in my building) wasn't feeling well. He'd quit drinking 2 days before, and decided to go to his doctor's office and wait for it to open.

While standing in the hall, Mr. Party was passed by a drug rep (yes, this one) coming to bring breakfast to me and Pissy's office. She markets anti-seizure medications, and her company has been promoting a campaign to make its reps more aware of the special needs of epilepsy patients.

Anyway, just as she was walking by Mr. Party, he suddenly collapsed and had a generalized seizure, wetting himself and lacerating his forehead on the doorknob as he fell. She then showed her newfound awareness of the special needs of seizure patients by running screaming through the building yelling "Help! Someone call 911!" repeatedly. The whole time she had a cell phone in her hand (Richard Dreyfuss did something similar in "Down & Out in Beverly Hills" for those who remember the flick).

Her meeting with me forgotten, she ran out to her car and decided to, um, I'm really not sure. As she was getting into it she suddenly realized she had a phone in her hand and called 911 herself. She then sat there for 15 minutes, trying to work up the courage to go back and look for her sample case and the tray of bagels she'd dropped in the excitement.

In the meantime, Dr. Smith had arrived at work to be greeted by one of his patients lying unconscious in a pool of blood and urine in front of his office door. At about the same time the police, firemen, and paramedics all arrived. They'd been summoned by the somewhat nonspecific nature of people in the building calling 911 when they heard the rep yelling, but not knowing what was going on.

Mr. Party was admitted to the hospital and is suspected of having had an alcohol-withdrawal seizure.

Dr. Smith waited until they loaded Mr. Party into the ambulance, then called building maintenance to shampoo the carpet in front of his office.

The drug rep found her sample case and bagels, and rescheduled her meeting with Pissy and I to later in the morning. During it she mentioned that she's considering a career change.

Midnight. Not a sound from the pavement.

Dr. Grumpy: "So that was 2 weeks ago that you were in the hospital... How have you been doing?"

Mr. Percheron: "I'm fine, I mean, I don't remember much about that day, but everything else has come back. What was that called?"

Dr. Grumpy: "Transient Global Amnesia. It's uncommon, and fortunately generally benign. You'll probably never remember the day it happened, but that's not a big deal."

Mr. Percheron: "Maybe you can help me with this?" (hands me a folded paper).

Dr. Grumpy: "What is it?"

Mr. Percheron: "It's from the hospital. They sent me a satisfaction questionnaire about my stay. But I don't remember anything about it."

"That's not my specialty."

Seen in a chart:

Research

I think we'd all agree that going through alcohol withdrawal is a bad thing.

I think even more of us would say that having a stroke is also pretty serious.

So you definitely don't want to do BOTH at the same time.

Of course, someone had to actually study this. So they did.

In a landmark piece of research, it was discovered that people who have a stroke AND go through alcohol withdrawal during their admission have more complications, poorer outcomes, and tend to be in the hospital longer than stroke patients who don't withdraw and see pink elephants.

Really.

This creates an all new research path: think of other conditions that are worsened by alcohol withdrawal. It's just like Mad Libs! Write a series of articles where you fill in the blank:

“Alcohol withdrawal is associated with worsened outcomes in  _______.”

If you play your cards right, this kind of research could get you an academic appointment! Let me throw out some suggestions, and you guys can take it from there:


"heart attacks"

"life"

"karaoke"


Have fun! And keep me in mind when you become chairman!


Thank you, SMOD!

"Play with me, kids"

There's a pediatrics office down the hall from me. Yesterday a letter for them accidentally ended up at my place, so I took it over there. I noticed this on the waiting room toy shelf:

Adulting

11:45 at night. My cell phone rings, waking me from sleep.

It’s Craig.

Dr. Grumpy : “This is doctor. … I mean, hi, Craig. You okay?”

(loud noise, someone yelling in background)

Craig: “Hi, Dad. Hey, how do I put out a fire in a microwave?"

I’m suddenly REALLY AWAKE.

(loud crash)

Craig: “Never mind, my roommate put it out.”

Voice in background: “What a mess, I'm going to get some towels."

Dr. Grumpy: “What’s going on?”

Craig: “Oh, nothing big, I guess. Hey, what’s a good way to get smoke out of a dorm room?”

Dr. Grumpy “Open the door and all the windows and put that fan you have in one of them.”

Craig: “Hang on… Okay, where’d I put the fan… guess that outlet isn’t going to work anymore, I’ll call maintenance in the morning.”

Dr. Grumpy: “Craig, what’s going on?”

Craig: “We were just making cookies, it’s fine now. I mean, it will be when the smoke is gone. Hey, can you order me a new microwave ramen dish thing from Amazon or something?”

Dr. Grumpy: “Why do you need a new one?”

Craig: “The other one is, um, kind of melted. I don’t think I can use it again.” (voice in background says something) “can you toss me some towels? Thanks. Sorry, Dad, there’s water everywhere. We had to throw a few buckets of water inside the microwave. (voice in background says something) I don’t think we can eat it, with the plastic melted into it on that side.”

Dr. Grumpy: “What…”

Craig: “Hand me the bag, I’ll just toss the ramen thing in there. OW! SHIT! IT’S HOT! SHIT! Hey, Dad, I think I burned my hand.”

Dr. Grumpy: “Put ice on it.”

Craig: “Will a cold Diet Coke can be okay?”

Dr. Grumpy: “If it’s all you have.”

Craig: “Okay.”

Dr. Grumpy: “Craig, What’s going on?”

Craig: “Oh, … We were just trying to make cookies. My roommate and I felt like cookies, so we bought a tub of cookie dough at the store.”

Dr. Grumpy: "You were making them in a microwave ramen dish?”

Craig: “It’s all we had, so we filled it up with dough, more like a cookie cake, I guess, figuring that way we’d be able to cook it all at once."

Dr. Grumpy: “Didn't the dough's microwave directions give you a time?”

Craig: “The tub didn’t have microwave directions, just regular oven, so we used those, but i guess that was too long. The cookie cake exploded and the bottom of the ramen pan melted and was smoking, then caught fire. My roommate tried to smother it with some paper towels, but then they caught fire, too."

Dr. Grumpy: “I wouldn’t…”

Craig: “Some guy on YouTube said it would bake them, but it didn’t. Hey, how long will it take all the smoke to clear from my room? I want to go to bed.”

Dr. Grumpy: “So go to bed.”

Craig: “I don't want to go to bed and leave all the doors and windows open, someone might steal my stuff.”

Dr. Grumpy: “Maybe a few hours.”

Craig: “Oh, good. I thought it might be days."

Taking a break

Gang, due to a great deal of insanity I'm going to take a few weeks off from the blog. Hoping to be back on November 18, 2019.

All is fine, but I need to decrease the things I'm juggling for a short time.

See you then!

I'll tell you where you can put your shoe

Here's another great computer chart system. When you order a shoe for someone who just had foot surgery, it gives you a list to pick where the shoe should be worn:

Thank you, J!

"I should do WHAT with it?"

Casa De Mentia

Jack is a nice guy, unfortunately now progressing through Alzheimer's disease. Although his cognition is shot, his baseline friendly personality has stayed with him. He's always accompanied by his doting daughter, Susan, and yesterday there was a guy with them I hadn't previously met.


Dr. Grumpy: "Hi Jack, hey Susan. Have a seat. Hi, sir. I don't think we've met. Are you Jack's son?"

Guy: "No, I'm, uh, actually a tax auditor."

Dr. Grumpy: "A tax auditor?"

Susan: "Yes, I asked him to come with us today. He's auditing our taxes."

Guy: "They asked me to come today. I don't normally go to doctor appointments with people. Actually, this is a first."

Dr. Grumpy: "What's going on?"

Susan: "Apparently there's an issue with our taxes. Can you explain?"

Jack: "Hi, Dr. Gravy."

Susan: "It's Dr. Grumpy, Dad."

Guy: "I was sent to audit their taxes because of errors that were, incredulous, to say the least, and my department was concerned about fraud, but when I got there I found that..."

Susan: "Me and Larry have been letting Dad do our taxes."

Dr. Grumpy: "WHAT? You mean, recently?"

Susan: "Yes, ever since we got married 35 years ago. He's always done them."

Dr. Grumpy: "Jack, have you been doing their taxes?"

Jack: "Are we going to be done here before the Cubs game starts?"

Susan: "Daddy, it's football season."

Dr. Grumpy: "Wait... Susan, you let your Dad, who we've done all kinds of paperwork and POA and legal forms on for his Alzheimer's disease, DO YOUR TAXES?!!!'

Susan: "I asked him if he'd still be able to do them, and he said yes."

Jack: "I'm a CPA. Last week I was named to the top 10 CPA's in Bayonne."

Susan: "Daddy, you've been retired for 15 years."

Jack: "Is the Cubs' game on tonight?"

Guy: "Excuse me, doctor, but just to make sure, is this man mentally capable of doing income taxes?"

Dr. Grumpy: "NO. Absolutely not. Do you need me to put in writing?"

Guy: "Please."

Susan: "Dr. Grumpy, I have a question?"

Dr. Grumpy: "Yes?"

Susan: "Do you know a good accountant?"

License plate of the year

Thank you, Glenn!

Random pictures

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


From the "you need a hobby" files:

One reader vacationing in San Diego sent in this picture of her hotel's emergency exit sign:

And now, to stress the importance of online security:

From the "Safety is job #1" files:

And, finally, "chewy" is apparently now a flavor:

"It. Tastes. Like. What?"

Mary's desk

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

Ms. Call: "Hi, I'm trying to reach Dr. Freenbeen."

Mary: "He doesn't work here, this is Dr. Grumpy's office. Let me look up Dr. Freenbeen's number for you."

Ms. Call: "I already have it. I can't reach him. That's why I called you."

Mary: "Oh... We're not affiliated with that office at all."

Ms. Call: "Yes, but I still need to reach them. I can't get through. The internet says you're both neurology offices, so I figured you'd have a way to."

Mary: "No, we don't"

Ms. Cell: "There isn't some secret network that connects you people? I saw that on the internet, too."

Mary: "There is no such thing. I have the same phone numbers you do."

Ms. Cell: "You people are so unhelpful."

Click.

Beware of the Dragon

Seen in a chart:

Thank you, J!

College

College kid: "Uh, hello?"

Dr. Grumpy: "Frank, what's going on?"

College kid: "Oh, hi Dad... Um, with what?"

Dr. Grumpy: "I got copied on an email from the university this morning that last night you'd violated some dorm rule by having an extension cord going all the way down the hall?"

College kid: "Oh, that... Yeah, I promised them it won't happen again. It was just an extension cord, though. I think they're making a big deal over it. Everyone has an extension cord."

Dr. Grumpy: "They told me it went from your room, down a hall, down 2 flights of stairs, down another hall, down the main front staircase, through the lobby, and then outside and about halfway across the parking lot."

College kid: "Yeah, I, uh, it was actually pretty impressive. I had to borrow extension cords from a lot of people to do that."

Dr. Grumpy: "They said people were tripping over it."

College kid: "Well, I mean, that explains why it's against the rules, I guess. It's a good idea, actually, if you think about it."

Dr. Grumpy: "That's a big "if." Why weren't you thinking about it? And what the hell were you doing that you had to have an extension cord going that far, anyway?"

College kid: "You know, uh, Dave, that guy down the hall from me? The one with the weird BO? Anyway, we were arguing about how far the dorm's WiFi range goes, so decided to take my laptop into the parking lot to find out."

Dr. Grumpy: "It's a laptop. Why did you need an extension cord?"

College kid: "Well, that girl, Kelly, in my graphic design group, needed a battery for her laptop, and the one she ordered online isn't in yet, so I loaned her mine. So to get my laptop to work to test the WiFi I had to have it plugged in, and to get it far enough out there needed a REALLY long extension cord. So I had to borrow a lot of them from other people in the building."

Dr. Grumpy: "Why didn't you just connect your phone to the dorm's WiFi and walk outside to test it that way instead?"

Long pause.

College kid: "That's a, uh, really good question. Look, Dad, I have to go, because I've got a bunch of extension cords I have to return to people."

Avast ye, mateys!

It's International Talk Like a Pirate Day!

To celebrate, here's the pirate-themed heavy metal band (you probably didn't know this musical genre existed, did you?) Alestorm, singing about stealing rum and beer.

And the guy elevates rolling the letter "R" to an art form.

Seen in a chart

"Make up your mind, will you?"

Chief complaint

My colleague, Dr. L., says she's studying for her neurology boards, and was taking a practice test last weekend.

This question was on it, and she says she's never had a patient report answer E to her.

I'd have to agree. At least not without a Ouija board.

Thank you, Dr. L!

Thanks, Sherlock

A drug rep marketing an epilepsy medication brought lunch in for Pissy and I, so we were having the usual 30 minutes of catered sandwiches and pamphlets full of glossy pictures, graphs, and small print.

As we talked, she mentioned that, as part of her new-hire training, she was sent to volunteer at Camp Shaking Pines this past summer. This is a summer camp held for children with epilepsy who, for medical reasons, can't go to other camps. The purpose of her 3 days there was to "raise my awareness" of epilepsy.

Then she said "Doctor, do you know that some of those kids, the ones with seizures, will actually have seizures, right there, at seizure camp?"

I heard a thud behind me as Pissy's hand hit his face.

Breaking news!

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

DATELINE: LONDON

British police have apologized after what they previously described as a "huge drugs bust" turned out to be vegan cake mix.

Staff of Purezza, a vegan restaurant, were transporting a large amount of vegan cake mix in a suitcase when it was confiscated at Gatwick airport by transportation police.

After identifying the powder as cake mix, the bags were returned to the restaurant. The staff has offered the police free cake, though at press time the police haven't accepted.



DATELINE: NEW JERSEY

An 80 year-old woman had her vehicle stolen. While she was asleep in it.

Police say the lady had dozed off after parking her car, and when she woke found herself lying in the driveway. She had no recollection of being taken out of the car.

The car has since been recovered.



DATELINE: NORTHERN CALIFORNIA

No one was injured when a bear landed on a police car.

In an unusual chain of events, a Humboldt county sheriff's deputy was driving on Route 96 when a bear fell off a steep embankment and landed on his patrol car. The hood and windshield were smashed.

The surprised officer lost control of his bearmobile, which slammed into the embankment, rolled onto its side, and burst into flames.

This resulted in a small forest fire, that burned about half an acre.

The officer was unharmed.

The bear fled the scene, and was not available for comment.

Uh...

Today's post is dedicated to the marketing genius at Boehringer-Ingelheim pharmaceuticals who came up with this name for their veterinary portal:

Good luck on your job search.

Thank you, Webhill!

Free samples

Mr. Dixie: "Hey, doc, do you need to check levels on my seizure medication today?"

Dr. Grumpy: "No, I don't."

Mr. Dixie: "You sure? Like, need a urine sample?"

Dr. Grumpy: "No, and it would be blood, anyway."

Mr. Dixie: "Oh... Well, I thought you might, so I left a cup full of piss out in your lobby bathroom, just in case. It has my name on it."

Dr. Grumpy: "Um, we don't have sample cups out in the lobby bathroom?"

Mr. Dixie: "I know. I took it off your water cooler."

Big Donor

Dr. Grumpy: "How you doing today?"

Mr. Big Donor: "I'm tired. You wouldn't believe what happened to my daughter's husband last night."

Dr. Grumpy: "He okay?"

Mr. Big Donor: "My son-in-law, Todd, was hanging up some pictures last night and accidentally hammered his thumb. It was really killing him. Maybe he broke it. He ended up having to go to ER."

Dr. Grumpy: "Ouch. That must have hurt."

Mr. Big Donor. "So he finally went there around midnight, and they left him sitting in the lobby. He said they kept bringing all these people from ambulances in ahead of him, and this one lady who had something stupid, like chest pain, got taken right back."

Dr. Grumpy: "  "

Mr. Big Donor: "So he finally called me when he remembered I'm on the hospital foundation's board. I was so angry. I called Dr. Brown... you know him? He's CEO over there? I have his home number and woke him up and told him about this bullshit they were doing to Todd. He took care of it, and they got Todd back in the next 5 minutes. But it's such crap that I even had to do that. I mean, I'm not a doctor, but even I know how a health care system should work. But the dimwits in ER have no clue."

Seen in a chart

I have no idea what this means, or why it's listed as a therapy.