Random pictures

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

 

First we have this festive jewelry for the holiday season. Because nothing says "Christmas" like a, uh, "Christmas tree."

Next we have this pasta. It's not only artisanal, but it's also shaped like New Jersey. Talk about a win-win!

While we're on the food topic, here's a car decal that asks "What would Jesus cook? And why wasn't it being served in The Last Supper?"

The there's this place, which makes you wonder if the guy cutting your hair works naked. Based on the barbers I've been to, I probably wouldn't go there.

And, lastly, is this article. The fact that it's filed under "meat industry" is kind of unnerving.

 

Friday

An attorney I've worked with called late Friday morning. A demented homeless patient had been found living in a culvert, completely disoriented. There was no known family. The small hospital he was at didn't have a neurologist available and they needed one to evaluate cognitive status for legal reasons. Would I be willing to do it?

My afternoon was actually fairly empty, as Fridays tend to be. So he emailed me the necessary paperwork and releases and I set off across town. After the usual COVID swab, then getting lost trying to find the correct room, I was there.

He was in his late 70's. The nurses had done an excellent job of cleaning him up (nurses deserve far more credit for this sort of thing than they ever get). Now he was in a hospital gown and adult diapers, still smelling slightly of urine, mumbling on and off, and occasionally asking me what school we were in.

I examined him, then sat down with his chart and some old medical records that had been scrounged together, looking to make sure the right things had been checked and ruled-out, the usual stuff that's second nature at this point in my career. I filled out a few papers, scanned them with my phone, and sent them off to the lawyer. I was done.

As I stood up to go I noticed a small pile of random objects on a chair in the corner and realized they were what had been found with him. His only worldly possessions, as the phrase goes.

Curious, I looked them over. A few T-shirts, a pair of socks, a metal water bottle and 2 plastic ones, some unopened bags of candy, 2-3 small stuffed animals. Somewhat incongruously there was a framed picture of a group of 5 men, all in 1970's-ish business suits and ties, standing behind a conference table, all smiling. The table had some scattered pens, note pads, coffee mugs, and a telephone. There was no name or date. The guy 2nd from left was the one lying in the bed behind me.

I have more things than he does, but neither of us gets to take them with at the end.

Out of all the items in the small pile, the picture obviously meant something to him. It was about 8" x 10", and certainly not easy to hold on to through all changes that a life of homelessness brings. But of the things that had connected him with who he'd once been, that was the one he wasn't going to get rid of. Even in the waning shadows of Alzheimer's disease he still thought it was important.

It led me to wonder how he'd reached the current situation. But the possibilities are large, varying from bad decisions to just the terrifying bad luck that can hit any of us. I had no way of knowing, nor was I going to guess. That's not what I was there for.

The things in that small pile were the only ones of value left to him. I suspect the photo was the most prized, simply because, unlike everything else on the chair, it couldn't be replaced, and he'd kept it for 40-50 years.

The detritus of a human life.

Wait, what?

I ordered a cheap pedometer last week after my old one broke. This was the product description.

 

 

Ancient History

Dr. Grumpy: "So what's going on?"

Dr. Aristotle: "I'm worried about my wife's thinking."

Lady Aristotle: "There is nothing wrong with me."

She sets down her coffee and glares at him.

Dr. Grumpy: "What concerns you?"

Dr. Aristotle: "She doesn't like reading Plato's Republic any more."

Pause

Dr. Grumpy: "I'm sorry, can you repeat that?"

Lady Aristotle: "You know what, Pericles? I NEVER liked it. I bet none of your college students ever liked it, either. And now that you're retired from BSU, I'm tired of hearing about it and pretending I even give a damn about Plato or his book! I did that for long enough!"

She picks up her coffee again.

Dr. Aristotle: "See, I don't think that's normal. You must have read it in college, didn't you Dr. Grumpy?"

Dr. Grumpy: "Um... actually I read the Cliff Notes."

Lady Aristotle: "SEE? I bet they all did, Pericles."

Dr. Aristotle: "But the Cliff Notes aren't the same. You must have gotten a bad grade just working off of that."

Dr. Grumpy: "I got a B+, but not liking Plato's Republic isn't a criteria for dementia. If it was most people would be diagnosed with it."

Lady Aristotle starts laughing.

Dr. Grumpy: "But to get back to the point of the visit, have there been other changes you've found concerning?"

Dr. Aristotle: "Well she... You know, I can't believe a college professor gave a B+ to a student who only read the Cliff Notes."

Dr. Grumpy: "Neither could I, but you did."

Lady Aristotle blew coffee all over my desk and started laughing so hard she got up and left. He went after her.

Reruns

As my regular readers know, I moonlight as a consultant for various medical market research companies. It's a thankless job, but somebody has to pay for the tomatoes.

So last night I had a dinner meeting with neurologists and sundry other specialists to review data on an up-and-coming product.

These are never fun, because neurologists by nature are a remarkably pathological group of personalities. Back when I worked at Humungous Neurology, Inc. the partners would argue if it was dark or light outside. I think they invite the other specialties to these as a buffer.

But I digress.

So I was seated next to Dr. Harangue, who I'd had the good fortune of not having seen in at least 5 years. In his own mind he's a giant in his field. To those outside his mind he's an obnoxious boil. He may have once been a good doc, but as they say in Hollywood "you're only as good as your last picture". And his was made before Casablanca.

Neurologists will argue over anything. The meal started with a dispute across from me over who's bread plate was who's (right or left? GET YOUR BREAD OFF MY PLATE!) followed by a fight over which fork is used for salad. Somebody actually dragged the maitre d' to the room to settle the issue (no, it wasn't me. I sit still and keep my mouth shut as much as possible).

I'm not much into the swanky places they have these meetings at. I ordered a steak. I had no idea how complex this was.

Waiter: "How would you like that cooked?"

Dr. Grumpy: "Medium."

Waiter: 'That involves a light red center. Is that okay?"

Dr. Grumpy: "As opposed to..."

Waiter: "Well, rare is a pink center."

Dr. Grumpy: "Medium is fine."

Waiter: "I can do medium rare, too. That's a pink/red combo".

Dr. Grumpy: "What's wrong with medium?"

Waiter: "I'll just do medium-rare-plus for you. That's a pinkish-red."

Whatever. I'm trying to order a steak, not pick out draperies.

Then the talk began. Every time a doc involved in the study was mentioned, Dr. Harangue felt the need to interrupt and say "I know that doctor personally. We've been close friends for over 25 years." By the end of the meeting I was hoping they'd mention a study done by Hippocrates or Woodrow Wilson to see if he knew them, too.

After 15 minutes of talking, the speaker stepped out from behind the podium to show us all that his zipper was down, with his tucked-in shirt hanging out of it. A tactful internist promptly yelled "Christ! Your fly is open!" to drop a subtle hint.

Then they brought dinner. The cardiologist next to me had ordered prime rib (no comment), and the waiter accidentally set my steak in front of him, and his prime rib in front of me. I pointed this out, and he quickly switched plates.

The cardiologist had a freakin' FIT! "I don't want that now! It was in front of him! He could have H1N1, or worse! Doesn't the heath department check you places anymore?!!!" It was, literally, in front of me for less than 5 seconds.

So I quietly started my steak, while they went to get Dr. Germaphobe a new prime rib (actually, I think they just brought him back the old one).

The next speaker showed us a seemingly endless series of graphs. After 20 minutes of this, she asked if anyone had any comments. Dr. Phlame at the end of the table immediately raised his hand. "Yes, I want to know why you chose red and blue as the main colors for the graphs. I think mauve and maybe yellow would be much more aesthetically pleasing. Also, I think some ruffles or curvy lines around the slide border would be nice."

This was immediately followed by Dr. Harangue chipping in "Dr. Phlame, do you live under a freaking rock? This company has been using those colors for years. But back to the data, did any of you people think to compare these results to a 1954 study by Longdead, et al?" The speaker (and everyone else there) had absolutely no clue what he was talking about, and Dr. Harangue chewed us out, as if it had just been published last week. When I looked it up, the study investigated a drug (that's no longer in use) for an unrelated condition.

Throughout this excitement the waiters kept refilling our glasses (ENDLESS DIET COKE HEAVEN!), so dysfunctional personalities were not improving with repeated doses of Burgundy and other wines.

In one discussion, to argue a point about a competing drug, an internist actually reached into his pocket and pulled out a product insert. I swear! He had it with him, all scrunched up. After reading from it like it was a bible he sat down and began arguing with a pulmonary doc about when daylight savings time starts.

We made it through another 15 minutes of polite discussion before Dr. Germaphobe cardiologist began tapping my shoulder. "Hey, Ibee!"

I turned around "What's up?"

"Are you gonna finish your roll?"

Stunned, I looked at the bread roll I'd absently left on my plate. It was buttered, and I'd taken a few bites out of it. "Uh, no, I'm full".

"Thanks!" And he grabbed it. So the guy who'd refused to eat an untouched steak was now chomping on my partially eaten dinner roll. Amazing what a bottomless glass of white wine will do.

As we sat through another set of slides, Dr. Harangue's cell phone rang. He answered it, speaking loudly enough to be heard in the next county (i.e., his usual volume). "What? Yeah. No, I've got another half hour of this shit. The drug company people won't shut up."

The dinner ended 20 minutes later. To make sure all points were covered, the moderator specifically asked "Dr. Harangue, are there any other comments?"

No answer. It was the only time he'd been quiet all night. He was in a burgundy stupor, slumped face down next to his creme brulee. He was still there when I collected my paycheck and left.

Seen in a chart

I have no idea what this was supposed to say.

 

 

Family Fun

Ms. Crouton: "Hello?"

Annie: "Hi, this is Annie, with Dr. Grumpy's office. I'm still working on getting your medication, Shnoodleblob, authorized, but in the meantime we do have samples you can pick up so you can get through the week."

Ms. Crouton: "You do? Oh, THANK YOU! That really helps. What time are you open to?"

Annie: "We'll be here until 4:30 today and..."

Ms. Crouton: "No... I don't get off work until 5:00 today, and I actually have to get off the phone now because my meeting is starting... can you call my mom for me? She knows I take this, and she's near your office anyway. She'll pick it up and I'll get it from her later."

Annie: "I..."

Ms. Crouton: "My meeting is starting! Please call her! 867-5309! Thank you!"

 

(click)

Annie sighs.

 

Ms. Crouton's Mom: "Hello?"

Annie: "Hi, this is Annie, calling from Dr. Grumpy's office. Your daughter, Ms. Crouton, can't get by to pick up her medication, and asked me to call you since she says you're near our office."

Ms. Crouton's Mom: "Can you please call my daughter back and tell her to go fuck herself? Thank you."

 

(click)

Annie sighs.

Never mind

Dr. Grumpy: "Any major illnesses run in your family?"

Ms. Dna: "Cancer, high blood pressure, type-2 diabetes... wait, do you mean in my family?"

Dr. Grumpy: "Uh, yeah."

Ms. Dna: "Oh, never mind then. They're all pretty healthy."

Back in 2023

But, until then, I'm again sharing my favorite Christmas song.

 

Saluting a colleague

Today's post is written to express my admiration for another local neurologist, Dr. I. V. Leeg, for his remarkable dedication to principles.

Dr. Leeg attended a well-known college and medical school. While the majority of people I've met who attended his school act like decent human beings, Dr. Leeg realizes that being in massive educational debt up to your eyeballs is worth nothing if you don't continuously remind other docs that they're road apples compared to you.

Dr. Grumpy went to public schools all the way up until medical school, when I went to a small private medical school no one else on Earth has heard of except for the 6 of us who graduated from there. My reason for going there? It was the only medical school I got into.

When I first met Dr. Leeg I tried to make idle chatter with him for a few minutes, and asked him what had brought him to this neck of the woods. Trying to be polite, he said "to improve the crappy quality of neurological care in Grumpyville."

Last year Dr. Leeg was fired from a hospital case because the family thought he was arrogant and condescending. They then asked for me to take over. In his sign-off note, he kindly put in the chart that he'd been "dismissed in favor of a physician of lesser education."

Recently a patient transferred care from Dr. Leeg to my practice, so I sent over a routine request for records. A week later we received them in the mail. At the end of the chart notes was a phone memo that said, "the patient has transferred care to Dr. Grumpy. I personally called to warn her of the risks involved in seeing a physician who is a product of public education. She understood, and unreasonably insisted on continuing with her plan to leave my practice".

So here's a salute to Dr. Leeg, for his remarkable devotion to making sure that us lesser physicians know our place in the world.

Open mic post

Doing some reading over the weekend, and came across this pic. I'm opening up the floor for caption ideas. Mine is under it.

 

“Pinch me again and you’ll need dental work”

 

 

"I'll never listen to Mozart the same way again."

Found this at Goodwill. I can only assume someone in OB/GYN marketing was trying to think outside of the pens & post-it notes box.

The personal touch

 Seen in a chart:

Random pictures

Time to hit the mailbag for stuff you guys have sent in.

Here we have an ad for a healthcare supply manufacturer.

Let's face it, if your most "innovative respiratory product" in the last 43 years is a cotton swab... I'm just sayin'.

Next, from the "hey, whose doesn't?" category, is this bumper sticker:

This license plate is presented without comment:

Next is this ER patient board item, which has either the wrong vowel or too many "r"'s. I'm not going to guess.

 

And finally we have this fortune cookie. Which probably means you've just been poisoned and need Ipecac.

 

Yes

Dr. Grumpy: "How are you doing?"

Ms. Random: "The morning is a complete loss so far. Truck empty. Overdoing it. Couldn't focus. Throwing things. Cats. Dogs. Crashes. Broken stuff. Shit. You ever have that kind of day?"

Modern technology

Mr. Galliform: "Annie asked me to type up my concerns and bring them in before my wife's visit."

Hands me a paper.

Dr. Grumpy: "Thank you, let me see. So sleep has been an issue?"

Mr. Galliform: "Yeah, she's often up pacing the hall and mumbling."

Dr. Grumpy: "Is she still driving?"

Mr. Galliform: "Yes, and I'd like you to discuss it with her, she's had all kinds of problems, and I think she needs to stop. I wrote some of that down towards the bottom."

Dr. Grumpy: "Oh, okay... she WHAT?"

Mr. Galliform: "Um, she's still driving, and it's causing problems."

Dr. Grumpy: "NO! Here, you wrote 'she frequently locks turkeys in the car'! When did that start? Why turkeys? That's a new one to me."

Mr. Galliform: "WHAT? Let me see... Oh, that must be autocorrect, it should say 'she frequently locks her keys in the car.'"

Pause

Mr. Galliform: "I have to admit, your version is more interesting."

Dr. Grumpy: "I bet."

Occupation

Dr. Grumpy: "Are you allergic to any medications?"

Ms. Golconda: "No."

Dr. Grumpy: "What kind of work do you do? Or are you retired?"

Ms. Golconda: "I'm a kept woman. And I'm very good at it."

Somewhere, across the sea, my readers write

Reader Alan K., from Israel, says his local grocery store recently had some issues with their "translate to English" website feature:

 

Little Shop of Horrors

This is Craig, reporting from the bakery.

For unclear reasons Local Grocery recently had a day where the store (for that matter the entire strip mall) was overrun with flies. We have no idea why. It was kind of like The Amityville Horror, but with a produce section and canned soup aisle.

Since this isn't exactly the kind of thing that attracts people to grocery stores, the management pulled out all the stops to get rid of them, with exterminators, zappers, No-Pest strips... everything short of calling Rent-a-Frog.

 

Hi, Ho. You rang?

 

Anyway, this particular night my shift-mate happened to be a girl named Marie (I kind-of know her, which can be kind-of embarrassing).

As the shift died down and closing time inched up, we began running out of things to clean, donuts to box-up, and cake orders to enter. So Marie decided to turn her attention to dealing with the flies.

She wandered off to get a fly-swatter, but came back with something entirely different.

Apparently, Local Grocery's floral & plant department had recently gotten in a shipment of Venus Flytraps for Halloween.

 

 

 

Oops, I meant Dionaea muscipula:

 

 

So Marie noticed them, piled them into a shopping cart, pushed it back to the bakery, and set them all over the counter, cake display, cookie island, and pretty much everywhere people looking for baked goods would be thrilled to encounter a carnivorous plant.

Marie, apparently having seen the Rick Moranis musical WAY too many times, was under the impression that the plants were aggressive stalk-and-ambush predators, capable of annihilating the store's swarm of flies in a matter of minutes (why they hadn't done so in the floral department didn't occur to her for some reason, and I learned long ago that arguing with her was pointless).

"I'm a mean green mother from... uh, the bakery department."

 

 

She got out her phone to film it, apparently thinking we were about to witness the Grumpyville Flytrap Massacre and it would really boost her YouTube channel. She was still waiting when the shift ended.

As anyone who's actually owned Venus Flytraps can tell you (like my Dad, who she apparently doesn't listen to), if they catch 1-2 flies a year it's impressive, the ones they do catch are the stupidest, slowest, ones of the swarm (it's called evolution, folks), and it takes at least a week to eat each one.

The store closed at 11. I got woken up at 3:00 a.m. by the morning shift donut & bagel baker, calling to find out why there were Venus Flytraps all over the bakery. I told him to call Marie and went back to sleep.

I heard her phone ringing in the next room as I dozed off.

Sigh

Dr. Grumpy: "Are you allergic to any medications?"

Mr. Protist: "Um... I got really sick once from amoebic dysentery. Does that count?"

Annie's desk

Annie: “Dr. Grumpy’s office, this is Annie.”

Ms. X: “Hi, I was wondering if I could talk to Dr. Grumpy, I have a medication question?”

Annie: “Well, can you tell me…”

Ms. X: “I just need to know, hypothetically, what would happen if someone stopped Ozbixacu abruptly in a 9-year-old boy.”

Annie: “Dr. Grumpy doesn’t see anyone under 18. Are you a patient? Who is this?”

Ms. X: “My name isn’t important. I need an answer. Now. Either give me the answer or get the doctor on the phone.”

Annie: “Look, I can’t just…”

Ms. X: “I am so done with you so-called medical people.”

Click

Random pictures

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

First, from the Guardian Angle Department:

Next is this lodging establishment:

 

Here we have a recycling can, apparently for people with partial bisection injuries (I don't think Darth Maul counts as "partial").

One reader says she discovered this uplifting decor at her dentist's office:

And, lastly, nurse Jenn says this drawer is in the galley of the nurses station she works at:

 

In memoriam

This is the launching of the aircraft carrier HMS Queen Elizabeth, July, 2014.

Photo credit AP

 

This is the launching of the battleship HMS Prince of Wales in May, 1939.

 

 

If you look carefully, the same lady is in both pictures:

 

 

 

Seen in a chart

 

Friday afternoon

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

Debbie: "Hi, it's Debbie, Dr. Nerve's office manager. Are you going to be covering his new partner, Dr. Axon's, hospital patients this weekend?"

Dr. Grumpy: "Does he have any hospital patients?"

Debbie: "No. He doesn't even have hospital privileges yet, so he won't have any hospital patients."

Pause

Dr. Grumpy: "Then why are you asking?"

Debbie: "Because Dr. Nerve told me to."

Undercover Angel

Dr. Grumpy: "What can I do for you?"

Mr. Bedsheet: "My wife says I kick in my sleep."

Lady Bedsheet: "He does! About an hour after he dozes off his legs start thrashing around, and it keeps me up."

Dr. Grumpy: "Do they..."

Lady Bedsheet: "Actually, I took a video of him doing it last night. Would that help?"

Dr. Grumpy: "Sure, why don't you put it on and I'll have a look."

Lady Bedsheet: "Let me get my phone." (rummages in her purse)

Mr. Bedsheet: "Doc, do you mind if I come around to that side of your desk? I want to see what it looks like myself."

Dr. Grumpy: "That's fine, why don't you stand right there." (I took a swig of Diet Coke)

Lady Bedsheet: "Okay, this woke me up just after midnight last night, you can see them kicking here..."

(I suddenly tried desperately not to blow Diet Coke all over her phone)

Mr. Bedsheet: "WHAT THE FUCK, HARRIET? WHY IS THAT IN THERE?"

Lady Bedsheet: "What was I supposed to do? You always sleep in the buff."

(I managed - barely - to get the Diet Coke down) 

Mr. Bedsheet: "YOU COULDN'T HAVE TAKEN IT FROM A DIFFERENT ANGLE?!!!"

Lady Bedsheet: "A different angle? Who am I, Spielberg?"

Mr. Bedsheet: "WHY DIDN'T YOU PUT A SHEET OVER MY CROTCH OR SOMETHING?"

Lady Bedsheet: "Look, Dr. Grumpy is a doctor. I'm sure he looks at schlongs all day in his job."

Mr. Bedsheet: "He's a brain doctor! They don't look at schlongs!"

Lady Bedsheet: "Dr. Grumpy, is this true? Do brain doctors look at schlongs at work or don't they?"

Dr. Grumpy: (desperately trying to regain control of the appointment) "Um, how many nights a week does this happen?"

Mr. Bedsheet: "What? That she films my schlong? Apparently at least once."

Lady Bedsheet: "Harold, can you stop saying 'schlong'? I'm sure the doctor would prefer a more medical term."

Mr. Bedsheet: "I think he'd prefer you go sit in the waiting room."

Lady Bedsheet: "Fine. Dr. Grumpy, did you see enough of the video to understand what's going on?"

Dr. Grumpy: "Most definitely."

Mary's desk

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

Ms. Cricetinae: "Hi, um, can Dr. Grumpy work me up for fur, I mean hair, loss, and weight changes?"

Mary: "No, you'll need to call your family doctor for that."

Ms. Cricetinae: "Well they won't see me for it."

Mary: "Well, I don't know what to tell you there, but Dr. Grumpy doesn't..."

Ms. Cricetinae: "Okay, the truth is that it's my hamster, Tulip. He's been losing weight, and fur, and I think he needs his thyroid checked and other stuff, but I don't want to pay for a vet. Can't Dr. Grumpy just draw the labs and bill them under my name to my insurance and say they were for me?"

Mary: "No, we can't do that. It's fraud. And Dr. Grumpy doesn't see hamsters, or know much about them."

Ms. Cricetinae: "But what about Tulip?

Mary: "Take him to the vet."

Ms. Cricetinae: "Thanks for being totally useless."

Click

Saturday night, 8:24 p.m.

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

Mrs. Cartography: "Hi, I'm sorry to bother you on a weekend, but I'm on vacation and I guess I forget to bring my Fukitol pills."

Dr. Grumpy: "Okay, do you have a pharmacy you want me to call it to? Where are you?"

Mrs. Cartography: "I'm in Hawaii, in... hang on. It says this is Lahaina. Do you know a pharmacy here?"

Dr. Grumpy: "No but let me..."

Mrs. Cartography: "My phone says there's a Dumpster Drug in Honolulu. Can you send it there?"

Dr. Grumpy: "Yes, are you going there soon?"

Mrs. Cartography: "It wasn't planned, but I can if I need to. We have a rental car."

Dr. Grumpy: "Honolulu is on another island. You're on Maui."

Mrs. Cartography: "I know Hawaii is an island. I'm not stupid."

Dr. Grumpy: "It's several islands, and Lahaina and Honolulu aren't on the same one. Let me look up a pharmacy in Lahaina for you, hang on..."

Mrs. Cartography: "Well, I'd rather go to Dumpster Drugs, because I use them back home. Why don't you just call it in and we'll drive there tomorrow?"

Dr. Grumpy: "You can't drive from Lahaina to Honolulu."

Mrs. Cartography: "I'm sure you can, there must be bridge or something. I mean, that's what I do when I'm going to Brooklyn."

Dr. Grumpy: "It's not quite the same. Let me..."

Mrs. Cartography: "Oh, never mind. My husband found the Fukitol bottle in my purse. Have a good weekend, doctor."

Memories

Going through some old emails over the weekend, I found this one to my office staff. I wrote it roughly 10 years ago, during a family trip to Disneyland.

While waiting to get in this morning we passed a lady yelling at a park employee outside a ticket booth. She was quite upset that the "special Disneyland admissions" she'd bought for a few $100 bills wasn't going to get her into the park. Or anywhere.

Lady: "I demand you honor these tickets! They say they're official tickets, and I paid good money for them."

Employee: "Ma'am, I'm sorry, but these aren't tickets. Did you get them at your hotel desk?"

Lady: "NO! The desk was ridiculously expensive. These were much cheaper. I got them from a man selling them at the bus stop in front of my hotel."

Employee: "I think you've been scammed. I can call the police if you wish. He wasn't a Disney employee, and these aren't real tickets."

Lady: "Of course they're real! They have a picture of Mickey Mouse on them."

Employee: "Yes, but that doesn't make them real tickets. In fact, that's a decal of Mickey stuck to them. It looks like they were made on a home computer."

Lady: "Well, he SAID he was an authorized Disney ticket sales person, and was wearing a hat with Goofy on it. Why would he lie about that?"

Beware of the dragon

 Seen in a chart:

Wait, what?

Pissy and I are talking to a drug rep.

"So, doctors, this nasal spray contains batsonshazam, that can be used emergently to stop a seizure, or attack of seizures. It comes 2 units in a box, which is convenient, as it allows patients to keep one at home and one at work, or one in the car, so they can even use it if they have a seizure and lose consciousness while driving."

Guidance

So today, me, and pretty much every doctor, veterinarian, nurse practitioner, and pharmacist in the country got this email:

Apparently the folks at the DEA (Drug Enforcement Administration) decided that people reading the rules about guidance didn't have enough guidance, and so needed some guidance. Or they just made a bet over the weekend on who could use the word "guidance" in an email the most:

 

 

Isn't that impressive? Okay, so what does the guidance in this remarkable document on guidance say? I'm glad you asked!

Here's page 1 (page 2 is more of the same, so I'm not going to bother with it).

 

 

For those of you who went to college in the same era that I did, I keep thinking of the word "guidance" now in the same way I used to think of the phrase, "Hi, Bob."

 

You're in luck

I take my 11:30 patient back to my office.

Dr. Grumpy: "Hi, Don, have a seat. How are you doing?"

Mr. Epazil: "Sorry if I'm in a rush, doc."

Dr. Grumpy: "Everything okay?"

Mr. Epazil: "Yeah, but I  have an appointment with Dr. Grumpy at 11:30. I think he's also in this building, but I can't remember where."

Pissy. Must. Die.

Me, Dr. Pissy, and our combined office staffs are having lunch with a drug rep.

 

Ms. Pharma: “That covers all the new info about Nomoshakin, so next time either of you sees a patient with refractory seizures, please keep Nomoshakin in mind. Any questions?” 

Dr. Grumpy: “No, thank you.” 

Ms: Rep: “Okay. Looks like we still have a few minutes, so let me tell you about Gramzap. This is our new, highly potent, highly absorbed, once-daily oral antibiotic. It has excellent coverage against many commonly encountered infections and…” 

Dr. Pissy: “Do you have samples?” 

Ms. Pharma: “Of course! Let me…” 

Dr. Pissy: “Please leave them for Dr. Grumpy. Gramzap sounds better than the weekly shots he gets at the free clinic."

Quote of the day

"I was in the ER last weekend for a seizure. They said my Kepdepatrol level was 4. Or maybe it was 8, actually, it could have been 14, or maybe 28. Whatever it was, it had either a 4 or an 8 in it, I'm not sure which. Does that help?"

Things seen in charts

 Here's this one, showing the hazards of cut & paste:

 

Next we have this bit of bullshit, which was, sadly, the entirety of the chart note and which told me nothing:

 

Apparently someone is hoping there's a CPT billing code for "vice versa:"

Next is another piece of crap someone pasted in. I'm willing to bet that the physician involved pastes this in at the end of pretty much every single note they write.

 

 

 

 

And, lastly:

Translation: just because I'm billing your insurance for treating a disease, doesn't mean you have that disease.

There are 11,000 neurologists in the U.S.

And a few weekends ago, due to a computer glitch, every one of them had an inbox that looked like this:

Voicemail theater

Message left at  6:55 a.m.

"Hi, thith ith Mike Thmith. I haf to canthel my appointment wif Dr. Grumpy for thith morning. I wath in a barfight lath night and loth thome teeth and have an emergenthy dental appointment. Thorry."

Message left at 7:00 a.m.

"Good morning, this is Dr. Perry O'Dontis. I'm sorry, but I'm going to have to cancel and reschedule my appointment with Dr. Grumpy for this morning. My partner is out of town, and one of his patients got into a barfight last night and had his teeth knocked out, so I need to work him in this morning."

Weekend on call

I've been called down to ER to see a fellow who suffered a stroke while at the local casino. His wife has just arrived.

Dr. Grumpy: "I'm glad you're here... his face is kind of drooping on this side. Is that normal for him?"

Mrs. Alteplase: "Let me see... He always has that."

Dr. Grumpy: "Okay. Do you know what medications he's on?"

Mrs. Alteplase: "No, but check his wallet. He always has that."

Dr. Grumpy: "Okay" (I start searching through the guy's pockets). "You know where he keeps it?"

Mrs. Alteplase: "No, but he always has that."

As I find and pull out the wallet a handgun - with the safety off - falls out of another pocket and lands on the floor with a loud THUNK. Me and 2 nurses freeze for a second, afraid it might go off.

Mrs. Alteplase: "He always has that."

Bathroom humor

A reader sent in this picture, where apparently an "out of order" sign just wasn't enough:

 

Of course, art imitates life, and vice versa:

Review of Systems

Dr. Grumpy: "Do you have any other health issues?"

Mr. Toss: "On January 14, 1999, I threw up in a Taco Bell bathroom, but other than that I've been fine."

Accuracy

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

Mr. Plumbum: "Yeah, I got shot, and they had to take out the bullet."

Dr. Grumpy: "Where did you got shot?"

Mr. Plumbum: "Korea."