Going green

 

Dr. Grumpy: "How often do you get migraines?"

Ms. Thac: "About twice a week. I have one today, actually."

Dr. Grumpy: "Do they..."

Ms. Thac: "Do you mind if I take my migraine medicine here?"

Dr. Grumpy: "No, go ahead. Do you need some water?"

Ms. Thac: "No, thank you."

Takes a plastic bag and glass pipe from her purse, starts packing a bowl.

Memories

My first year at BSU I had this dumb-as-rocks dorm roommate. He wrote college reports in crayon, lost tuition checks his dad sent him, and routinely stepped on eggs our suite-mates had hidden in his shoes. Like most college guys, he was obsessed with meeting girls, but he had some, uh, non-traditional approaches.

1. Bizarre idea to meet girls #1.

Our dorm was co-ed. Odd numbered floors were women, even numbered were men.

Mike decided to bounce golf balls, LOUDLY, on the floor of our room. His idea was that the girls who lived beneath us (and he had no idea who they were) would then come up to our room, ask him nicely to stop, and he could invite them in.

All that happened was they called the building office to complain, and we got written up.

I wasn't even in the room at the time.

2. Bizarre idea to meet girls #2:

This involved, I swear, the lobby vending machine that sold little containers of milk. He noticed that a lot of women would get some milk to study with, so he set up camp near it with a shitload of quarters. Anytime he saw a girl going to buy some he'd get up and strike up a conversation while waiting his turn for milk. This idea was such a remarkable success that one night he returned to our dorm room with 18 containers of milk, out of money, and with no phone numbers. He needed to borrow quarters from me to do his laundry that night, because he spilled milk all over his shirt trying to drown his sorrows in overpurchased dairy products. He also discovered he was, after a point, lactose intolerant.

3. Definitely NOT a good way to meet girls:

Our room overlooked the lawn behind the dorm, and one spring day a lot of pretty girls were out sunbathing. Mike watched them for a while, and then decided to, uh, relieve some tension while doing so. For unknown reasons he didn't realize that if he could see them, they could see him.

Mercifully, I was downstairs on the patio with friends, so anyone who looked up and saw what was going on in my room could immediately see that I was definitely not the person up there.

I googled him last week. He sells real estate in Nevada now.

Graphic

Dr. Grumpy: "Any health changes since I last saw you?"

Mr. Otitis: "I had an ear infection, that was about it."

Dr. Grumpy: "Okay, so at your last visit I ordered an MRI of your back..."

Mr. Otitis: "It was a bad ear infection. I had to see my family doctor for it."

Dr. Grumpy: "All right, but..."

Mr. Otitis: "I mean, it was like bloody diarrhea, except it was gushing out of my ear."

I stop stirring my coffee and push it away.

Mr. Otitis: "Anyway, can we talk about my MRI?"

Dr. Grumpy: "Let's do that."

The Beyond

Saturday afternoon

 

Andy: "Local pharmacy, this is Andy."

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

Andy: "Thanks for calling back, we've been trying to get a refill for Alma Childrin, on her Fuximab?"

Dr. Grumpy: "Hang on, let me look her chart up... Actually she died last month."

Pause

Andy: "So is that a no?"

When in doubt, cut it out

Dr. Grumpy: "Have a seat... So what can I do for you?"

Ms. Calgerepep: "I'm not sure I'm in the right place... I thought I was supposed to see a brain surgeon."

Dr. Grumpy: "That's definitely not me. What were you referred for?"

Ms. Calgerepep: "I have migraines."

Dr. Grumpy: "Actually, I do handle that. You are at the right doc."

Ms. Calgerepep: "What do you do for migraines?"

Dr. Grumpy: "Well, we can get into more detail on that later, after I take your history, but there's a large number of medication options."

Ms. Calgerepep: "I don't want medications. I just want the migraines taken out."

Dr. Grumpy: "I understand that, but treatment is really more finding the right medication for each person, why don't you tell me..."

Ms. Calgerepep: "See this is why I wanted to see a brain surgeon. I want someone who can just go in there and take the migraines out."

Dr. Grumpy: "Migraine treatment doesn't work that way, unfortunately. There really isn't a specific thing to take out."

Ms. Calgerepep: "Now you're lying to me. You just want to be able to bill me, when you aren't even the right doctor. We both know I need a brain surgeon to fix them."

Dr. Grumpy: "Ma'am, I promise you that..."

Ms. Calgerepep: "You must be in this with my family doctor. I'm out of here."

She leaves, slams door.

Seen in a chart

Thank you, B!

Random pictures

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

First we have this ad. Beer (at least  in my area), isn't typically sold as a "family pack."

 

"It's a good deal. I mean, isn't kindergarten old enough?"

Next, from the "It may be explosive, but I'm not so sure that's a spaceship" department:

A reader who ordered take-out pizza says the box stickers made her think all the guys working in the CPK kitchen were wearing condoms:

Then there's this unappetizing-sounding menu item:

"Why don't people order our crab rangoon?"

And, finally, a reader cleaning out some old boxes found this catchy-named catalog:

Multiple choice

Dr. Grumpy: "Is your family doc still Dr. Stevens?"

Mrs. Unsure: "No, I had to change."

Dr. Grumpy: "Okay, who..."

Mrs. Unsure: "I think she moved away, or retired. Actually, she may be on maternity leave. I could have that mixed up. She may have died, or maybe she didn't take my insurance anymore. Anyway, it was one of those sorts of things. I'm not really sure.

Mary's desk

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

Mr. Nmda: "HI! DOES YOUR OFFICE DO KETAMINE?"

Mary: "No, we don't. You might try the Ketamine center on the west side."

Mr. Nmda: "THAT'S TOO FAR TO DRIVE! DO YOU HAVE, LIKE, FREE KETAMINE SAMPLES OR ANYTHING YOU COULD GIVE ME? LIKE FROM A PROMOTIONAL THING?"

Mary: "No, that's just not something we handle in our practice."

Mr. Nmda: "IS THERE ANYONE IN YOUR BUILDING WHO HAS KETAMINE? I'M DOWN IN THE LOBBY, AND IT LOOKS LIKE THERE'S A LOT OF OFFICES HERE. SOMEBODY MUST."

Mary: "Not that I'm aware of."

Mr. Nmda: "IS THERE A BATHROOM IN THE LOBBY DOWN HERE?"

Mary: "Uh, on the west side, by the stairs and water fountain."

Mr. Nmda: "THANK YOU!"

Click

 

Zzzzzzzzzzzz

Sunday morning. 2:18 a.m.

 

Mr. Sleepy: "Hello?"

Dr. Grumpy: "Hi, Mr. Sleepy, this is Dr. Grumpy., we met yesterday afternoon. I'm the neurologist taking care of your mom."

Mr. Sleepy: "Ummm yeah. What time is it? You woke me up."

 Dr. Grumpy: "Sorry. I called because your mom took a turn for the worse about an hour ago. As you  know she had a stroke, and it looks like around 1:00 she had a serious heart problem develop. We called in a cardiology team, and I came in, too. Unfortunately, even with our best efforts, she died a few minutes ago."

Mr. Sleepy: "My mom died?"

Dr. Grumpy: "Yes, sir, the cardiologist is still in the room with nursing, but asked me to call you. He'll be out in a minute to answer..."

Mr. Sleepy: "You woke me up in the middle of the night to tell me my mom died? Are you serious?"

Dr. Grumpy: "Well, we thought..."

Mr. Sleepy: "I can't believe this. I mean, I'm not a doctor, but I'm pretty sure that if she's dead now, she'll still be dead in the morning when you could have called me at a more decent hour."

Dr. Grumpy: "Yes, but..."

Mr. Sleepy: "Don't they teach you people common courtesy in medical school?"

Dr. Grumpy: "Sir, I..."

Mr. Sleepy: "I'm going back to bed. Tell the nurse I'll call in the morning to make arrangements."

Click.

Seen in a chart

 

Needlework

Early last week I received a text from Local Hospital, saying that my name had come up in the hospital's mysterious vaccination hierarchy, and gave me a date and time to get my COVID-19 shot.

 It was in a part of Grumpyville that, quite literally, I didn't know existed. I assumed there was going to be a secret password or knock, but it wasn't included in the text.

So, at the appointed time, I drove to the secret site, which turned out to be the parking lot of an abandoned strip mall. The building itself, long-devoid of dollar stores, drive-thru liquor emporiums, porn shops, landscaping companies, and crematoriums, was apparently chosen for its massive parking lot, rather than the building itself.

 

"Are you shitting me?"

Local Hospital had set up a bizarre array of tents, traffic cones, folding tables & chairs, and outdoor heaters. Realizing that putting up a sign that said "COVID VACCINES HERE!" would bring in hordes of people who'd found it after taking the wrong freeway exit, they simply had signs that said "PRIVATE EVENT." This had the intended effect of making passersby think it was simply a large outdoor wedding, the kind that are commonly held in snow at an empty strip mall in the freezing Midwestern winter.

In fact, it fooled me (and most everyone else) judging by the number of confused people who pulled in and asked the heavily-swathed security guard (I'm pretty sure he had a flask of brandy somewhere on him) if this was where the COVID shots were .

 It was.

 

"No, it's not a cartel meeting, why do you ask?"

 

So I pulled up to the first table. At this point there was a sign saying to roll down the driver's side window and leave it down. I suppose this wouldn't matter back in my ancestral home of San Diego, but here in Grumpyville it was a balmy 28°F (-2 C) and there was a mild snowfall. And I'm sitting in this, with my car window open.

I pulled up to the table where another unidentifiable person/biped/android checked my hospital ID, driver's license, and appointment time, asked me if I had an elevated temperature (which really wasn't possible at that point), ran through a list of Coronavirus, SARS, and Ebola symptoms to make sure I didn't have any, then waved me on to the next table. It was kind of like being in the line of boats at the beginning or end of Small World, but without the music. And a lot colder.

At the next table they checked my temperature, pulse, and blood pressure. Like wearing masks, having someone point a gun-shaped thing at my forehead to check my temperature to go anywhere would have seemed entirely bizarre and creepy a year ago, and is now normal.

Finally I pulled up into the vaccine tent itself and stuck my left arm outside the car window. They asked me to put the car in park, as understandably a sudden lurch forward with sharp objects involved was undesirable. It was also the closest I'd been to one of the giant propane heaters, for which I was grateful.

After a minute, a person in some sort of giant Hazmat suit came over with a syringe and asked to verify my name.

 

 

"Ibee Grumpy."

"Hey, Ibee! Good to see you, it's me, Kim McBoob, under all this. Haven't seen you in a while."

 

Kim and I had gone to medical school together a LONG time ago. She went into radiology, then specialized in reading mammograms, and somehow we'd both ended up at the same hospital in Grumpyville.

 

Dr. Grumpy: "Kim, what are you doing out here?"

Dr. McBoob: "I was bored, no one has been coming in for mammos between the pandemic and holidays, so I volunteered to give shots."

Dr. Grumpy: "When was the last time you gave shots?"

Dr. McBoob: "Before today? Same time you did, back at the Big City VA."

 

At this point I was more terrified I was going to lose my arm than have a reaction to the vaccine. Dr. McBoob tried to make me feel better by saying...

 

Dr. McBoob: "Don't worry, they had us watch some Youtube videos on giving injections this morning. Hold on, this will sting a bit..."

Dr. Grumpy: "Aren't you  supposed to swab the site with alcohol first?"

Dr. McBoob: "Oh yeah, you distracted me. Hang on... There ya go! Now you can pull over to area 51, there, where the guy with the blue flag is."

I pulled over to the largest part of the parking lot. The wind had picked up and it had started to snow more. There a fellow gave me, literally, the following instructions:

"You doing okay? Good. Pull into space 27 there, where the lady with the yellow flag is. You'll need to wait 15 minutes. If you feel like you're having a serious allergic reaction, or you're, like, about to stop breathing, please honk your horn and turn on your hazard lights so we can come help you. Also, remember to leave your driver's side window down and the doors unlocked so we can reach you if needed."

Really, he did.

I pulled into space 27, by the lady with the yellow flag. She handed me a paper with the Lot number of my shot and the sentence "If you develop anaphylactic shock please remember to honk your horn and turn on your hazard lights."

 

"Pardon me, may I borrow your Epipen?"

 

 

So there I was. I've received a remarkable scientific breakthrough, and all I can think about is that my arm hurts, it's freezing cold, and snow is blowing into my car through the window I have to keep open. I was wondering, if I did call for help, would a rescuing nurse, doctor, or St. Bernard be more appropriate?

 

 

"You the guy who honked? Hello? Hello?"

 

Maybe I could ask the security guard to borrow his flask. After all, I'd now been vaccinated.

Faced with my bleak prospects for the next 15 minutes, I did what countless previous generations of Americans did in difficult circumstances: I played Toon Blast. Although my fingers were, admittedly, starting to get numb with frostbite.

After about 10 minutes yellow-flag-lady came over and asked me if I was having any trouble breathing. When I said no, she told me I could leave because they needed the parking space for the next person. I was more than happy to be able to roll up my car window and crank the heater up, 

For those of you who are curious, it hurt for about 2 days, longer than the flu shot, but not nearly as bad as the shingles shot.

And I'm still pretty pissed that it hasn't, to date, caused me to develop cool superpowers.

 

 

Also, is anyone else pissed off that Cyborg replaced the Martian Manhunter in the JLA reboot?

 

Legal adults

Craig: "What's that?"

Marie: "It's a box of mini-quiches Dad got from Costco. I'm making some for breakfast."

Craig: "Is there more than one kind?"

Marie: "Uh, it says some are spinach and cheese, and some are bacon and cheese."

Craig: "Can you make extras and I'll have some?"

Marie: "Sure."

Craig: "What kind do you want?"

Marie: "I'll just make the whole tray, and I'll eat whatever ones you don't want."

 

Fifteen minutes later

Marie: "Hey, how came all the bacon ones are gone?"

Craig: "I ate them."

Marie: "WHY DIDN'T YOU SAVE SOME FOR ME?"

Craig: "You said I should eat whatever ones I wanted, and you'd eat the rest."

Marie: "So you only left me spinach ones?"

Craig: "I hate spinach."

Marie: "You still should have saved me some bacon!"

Craig: "That's not what you said!"

Marie: "But they're my favorite, you dickhead!"

Dr. Grumpy: "Uh, I have to go to Costco today, I'll just get another box."

Marie: "And I get all the bacon ones."

Craig: "I'm not visiting your island in Animal Crossing if you're going to be this way."

Memories

It's been about 9 years since BlackDog died, so here's the whole story.

She'd been in declining health for some time. Not visibly suffering, but obviously going downhill bit by bit.

Toward the end she'd gotten increasingly lethargic, and at work one day I suddenly realized she'd died at home just then (don't ask me how I knew, I just did).

So I went home before the kids got there, and sure enough she was gone. She was in her usual sleeping place by the couch, looking pretty peaceful. I got a stethoscope out of my hospital bag to check (I'm a neurologist, so it was the first time in years I'd actually used one).

Obviously, getting rid of a decent-sized (60 lbs) dog isn't something easy to do. She was too big to quickly dig a hole for, I wasn't going to toss my longtime friend in a dumpster, and other things just didn't seem like a good idea:

So I carried her out to the car and called our vet to warn them I was bringing in a dead dog.

When I pulled into the lot the office manager was waiting out there for me, to get me in through the back door. She didn't feel, somewhat understandably, that a guy carrying a large dead animal in through a crowded waiting room would be good for business.

So she led me in through the back and had me set BlackDog down in a room while she went to get some paperwork.

At this point Dr. Hypervet wandered by and glanced in the room. Apparently no one had told her that a dead dog was coming in.

She ran in and began yelling "TECH! I NEED A TECH IN HERE! THIS DOG ISN'T BREATHING!"

Some tech ran in. Dr. Hypervet started listening with her stethoscope. I calmly tried to tell her the dog was dead, but every time I opened my mouth she'd "SHUSH!" me, like she was a possessed librarian.

Finally, I yelled "STOP!"

She looked up at me like I'd just climbed out of the air vent.

"Look. She's dead. I brought her in for cremation, that's all."

Dr. Hypervet looked from me to the office manager, who'd just come back.

"SHE IS? Oh, I mean, of course, uh, yes, she is. Why didn't anyone tell me in advance?"

I said "I tried to."

The office manager said: "I did, but you said you were busy."

Dr. Hypervet carefully put her stethoscope back on and firmly said, "Well, I absolutely agree with you," and walked out of the room.

I think even BlackDog was laughing.

Seen in a chart

 

Medical inventions

Several years ago I posted about Local Hospital's bizarre "washing your hands entertainment system," where the soap dispenser has a screen that shows you seemingly random items while you lather up. This is on a par with the TV screen that provides apolitical bubblegum news while you're pumping gas.

Anyway, over time you guys have sent some of your own pics of this "keeping-your-mind-busy-while-getting-an-ATV-rider's-cortex-off-your-hands" distraction, so I thought it was time to share them.

First we have this, which may come in handy if you ever hear yourself saying "I'll take 'marsupials' for $400."

 

Then there's this one, which I'm guessing sent people back to their phone wondering "who?" and looking it up before they rejoined the code-in-progress:

 

Bizarrely, this next one is incorrect. That number is per day, NOT per hour:

 

One can only hope no one was injured when the ICU doc came back from washing his hands, called the respiratory tech over, and said "the hand-washing machine says we're doing this wrong, turn her rate up to 384 breaths per minute." 

 

 

 Here's this one, which gets back to the childhood "whoever smelt it, dealt it" game.

 

 

 

 

Finally, there's this pick-me-up, in case you need a reason to feel grateful after cleaning up an unhelmeted motorcyclist who attempted riding between 2 semis.

 

 

Today's quiz

 This picture is:

 

A. The new ad campaign for Dove "it's 1/4 moisturizing cream" soap.

B. "Phantom of the Opera II- The Return."

C. A really weird update on the milk mustache ad campaign.

D. A public service announcement about casual use of quick lime.

E. An advertisement for an unreleased Alzheimer's treatment still in development.

 

(Yes, it's E. Though I'm not sure that makes any more sense than the others)

Sunday, 3:47 p.m. voicemail

"Hi, this is Mr. Foggy. I need to cancel my appointment with Dr. Grumpy for this week. It's, uh, one of the days this week. Actually, maybe it's next week, or the week after that... I'm sure it's sometime this month. Anyway, can someone please call me back and tell me when my appointment is so I can cancel it?"

It's been such a long time

One of my longstanding patients, Mrs. Laugh, came in this week.
 

Dr. Grumpy: "How are you doing?"

Mrs. Laugh: "Fine. You know, I've been meaning to tell you how great you look for your age!"

Dr. Grumpy: "Thanks. I had no idea that looking great in middle-aged now meant pudgy and balding."

Mrs. Laugh: "Oh, I think you're beyond middle-age!"

Dr. Grumpy: "All right... Where are you going with this?"

Mrs. Laugh: "Well, I was looking up your profile on shittydocratings.com and found this:" (holds up iPhone)

 

Skool Nerse Tyme

This is Mrs. Grumpy.

So many of you have returned to Douglas C. Kenney Elementary School these days. It certainly keeps me busier, as your friends who are taking Zoom classes don't get sent to the nurse for itches, life-threatening pencil pokes, and sundry ailments that just happen to coincide with a math test.

I'd like to thank all the parents who filled out your information cards with such helpful items as "he's allergic to something, don't let him have any," a reminder not to give your child "stuff that might not be organic," and (my favorite) "do NOT allow her to get COVID!!!" Please keep in mind that I'm not the one who voluntarily sent your kid back to what is basically a 95,000 square foot fomite.

I'd also like to make a public service announcement: As you know, me and a handful of teachers have been assigned to screen you little darlings for fevers each morning, pointing that laser scanner at your forehead before you go inside.

It certainly alarmed us when we found large numbers of you were running fevers when you got off the bus. Not just fevers, actually, but temperatures in the 120 degree range. Which are, quite frankly, incompatible with human life.

Fortunately, Maxine, the lady who's been driving school buses since they were pulled by horses, called me onto the bus to see the discarded hand warmers from the camping supply store, which you frauds adorable children had been pressing to your foreheads and passing around.

As always, nice try. Now go to class.

 

Medical news

Journal headline writers apparently are now paid by the word:

Tech

 Logging into the pharmacy prescription portal to do refills this morning, I was greeted by this:

 

 

 

So, being the kind of doctor (I hope) who wants to make sure his patients are getting their medications, I click on the warning. It immediately brought up this helpful box:

 

 

That's all folks. No name, birthday, medication, anything.

Language

I recently didst endorse myself for an online continueth education lecture series, and amongst the linguistic choices there wast thine following:

 

 

 

Verily, I wouldst be most delighted to conduct such endeavor in the tongue of Geoffrey Chaucer, as I still have a copy of The Canterbury Tales from my salad days stored in the dusty lofts of my dwelling.

 

Though, if it would suit Ra and Anubis, I could also attempt to do it in Ancient Egyptian, provided I could find an appropriate app.

Forsooth.

Memories...

 

 

Back in the old days, before every phone had a GPS system and Siri to boss you around, we used an aging GPS gadget we named Bib (for "bitch in the box") that we'd bought secondhand.

Bib at the time was about 7 years old. She had an electrical short in her end of the connection that plugged into the car. For a few months we got her to work by (I swear) licking the leads before plugging them into her. Doing these steps in order was critical, as getting them reversed once caused me to take the charge from the car battery through my tongue. Which hurt.

Anyway, as it worsened, any bump we'd hit would turn her off and then she'd have to reboot, and find satellites, and we'd have to re-enter directions... you get the idea.

Of course, this happened once in a city we were entirely unfamiliar with, and were already having trouble finding our way around.

Bib, however, wasn't going to reboot this time. We pulled into a Target lot, and futzed around. But Bib was gone. Putting water, saliva, Diet Coke, whatever, on the contacts worked for about 10 seconds before she shut down again.

Since we were outside the store I figured I'd go in and see what they had for new GPS systems, when I had an idea.

I bought a small tube of K-Y jelly, and went back. Mrs. Grumpy was laughing hysterically at me, but I put a glop of it on Bib's electrical connection AND IT WORKED. Bib got us back to the hotel, and worked fine for the rest of the trip.

So, for the rest of the time we had her we kept a little tube of K-Y in the GPS gadget's bag, carefully applying some before attaching the cord.

At some point we left Bib, in her bag, with the K-Y, either at a Goodwill or E-waste collection. Someone out there opened the bag and is probably still wondering about it.

Prestige

My regular readers know that I'm not a member of any organizations, nor do I have a particularly high opinion of them.

It was Groucho Marx who said "I don’t care to belong to any club that will have me as a member" and I'll agree with that.

So recently, my reader SMOD (who belongs to the American Academy of Neurology) showed me this survey they sent him:

 

 

To comment on a few:

"Ability to network with other neurology professionals."

This is DEFINITELY not an enticement. If I really wanted to do this I could go to drug-company sponsored dinners or hospital meetings. There's a reason I don't: neurologists are, in general, social freaks. You could write a textbook about all the personality pathology that occurs in this field. We fight over reflex hammers, FFS. You think I want to hang out with other members of this tribe? There's a reason I'm in solo practice.

"Free or reduced rates on AAN products, services, or conferences."

The last time I went to a conference was when my job paid for it, which was 1998. If I'm going to blow a mortgage payment (or two) on plane tickets and hotel rooms, I'd rather have it be something I can do for fun with my family, and not to drag my ass to a darkened conference room to hear about possible breakthroughs using chupacabra urine-derived proteins for the treatment of MS. In 1998 I went to a bunch of those sessions, many standing room only, and I don't think any of the research I heard actually bore fruit in the long run. I'll take a beach chair and umbrella drink, thanks.

As far as AAN products go... at my last meeting (admittedly, this was a long time ago, so maybe you don't do this now) there was a booth selling AAN-themed T-shirts, baseball caps, coffee mugs, and reflex hammers. I'll pass, even with a discount.

"Distinction, prestige, and/or added credibility of being an AAN member."

This is, far and away, my favorite item that you've asked people to rate. I'd be checking the box under "was not aware of." I mean, to me this is like saying you belong to the Gilligan's Island Fan Club for the effect it has on the general public. People either aren't aware there was such a thing or they pity you for being so proud that you belong to it. There are a lot of ways to earn respect, like being a good doctor, citizen, or parent. Giving back to your community. Helping the less fortunate. But hanging a sign in your office that says you're an AAN member is only going to matter to drug reps, who will use the info to cull favor for you to prescribe their latest and greatest.

One could also point out that being an AAN member isn't something that's visibly obvious, like some sort of aura, that makes people take notice so you get a better table or they clear a path as you come through. Perhaps that's why you might purchase an AAN T-shirt or baseball cap, but not sure that's going to help. Out in public people could take it to mean anything, like Anal Aficionados of Nebraska.

"Distinction, prestige, and/or added credibility" in medicine, as in life, are earned by actions, not by paying a $495 annual fee. If you think otherwise, then you probably wouldn't want me as a member, either.

- Thank you, SMOD!

I guess I won't send him a letter.

 Seen on a new patient information form:

Marriage

Dr. Grumpy: "Have you had any surgeries?"

Mr. Chole: "I had my gallbladder out."

Mrs. Chole: "Wait, I thought I was the one that had my gallbladder out?"

Mr. Chole: "No, it was definitely me. Remember? I had to miss your sister's wedding?"

Mrs. Chole: "Like you regretted that, anyway. But I thought that was for a business trip, and I had my gallbladder out at Christmas that year because your mother cooked that horribly greasy turkey and made me sick."

Mr. Chole: "At least she could cook. I'm pretty sure I'm the one that had it out, though."

Mrs. Chole: "No, it was me. I have the scar to prove it. See?"

(pulls up her shirt)

Mr. Chole: "Let's ask the doctor. Dr. Grumpy, which of us had our gallbladder out?" 

(pulls up his shirt)

Dr. Grumpy: "Uh, I'd say you both did. Can you please put your shirts down?"

(they both pull their shirts down)

Mr. Chole: "Anyway, besides that, I didn't have any other surgeries."

Mrs. Chole: "Your mother still couldn't cook."

Seen in a chart