Tuesday, April 13, 2010

Mary's Desk, April 13, 2010

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

Mr. Biz: "Yeah, I have an appointment at 3:00 today, and my boss called an emergency meeting for the same time."

Mary: "Okay, do you need to reschedule?"

Mr. Biz: "No. Do you have WiFi?"

Mary: "Um, no, why?"

Mr. Biz: "Because I want to attend the meeting online during my doctor appointment. It's very important."

Mary: "I can reschedule you to tomorrow..."

Mr. Biz: "Wait a minute. You mean to tell me your office doesn't have free WiFi service? What do people do while they're waiting for the doctor?"

Mary: "He's usually pretty prompt, but we have magazines and..."

Mr. Biz: "How can you NOT have WiFi for patients? Just cancel my appointment, I'm going to find someone else."

Monday, April 12, 2010

Overheard at the Grumpy house computer desk

Frank: "Don't click on that button."

Craig: "Why not?"

Frank: "You know."

Craig: "I don't know."

Frank: "It will erase your file."

Craig: "How do you know?"

Frank: "I don't know."

Craig: "You don't know?"

Frank: "I know that you don't know."

Craig: "You don't know what I know because you don't know!"

Frank: "You don't know that!"

Craig: "I know!"

Monday non-sequitur

Dr. Grumpy: "Do you have any back pain?"

Mr. Huh: "No. I'm from Oregon."

Saturday night, on call

I'm sitting down to dinner with my family. My cell phone rings. It's the ER. A patient has just had a stroke, and is a candidate for the "clotbuster" drug, TPA. The drug MUST be given within 3 hours of symptoms onset. It's a serious emergency.

I leave my plate on the table, yell goodbye to the family as I run out the door. I race down the road, and onto the freeway.

I get to the hospital. I pull into one of the special "doctor emergency" slots by the ER entrance. I wave to Willy, the security guy who's been sitting there watching the lot for the last 40 years (he's rumored to be the last surviving veteran of the Spanish-American War of 1898).

I run in. I meet with the family as the patient is being wheeled to CT. He comes back. I look at the CT and call the radiologist. I examine the patient and go over the checklist for TPA, and explain the risks and benefits to them.

The family and patient are willing to throw the dice. The volatile drug is given as we watch. I re-examine him every few minutes. We get a bed in the ICU, and the patient is wheeled off. I write further orders and make phone calls to an internist and cardiologist.

Only time will tell.

And I walk out to my car, hoping to get home before the kids are asleep, and to have some dinner.

(click to enlarge)

Sunday, April 11, 2010

Stupid toy of the year award

While I was on call today, Mrs. Grumpy took the kids to Humungous House O'Toys. Because the kids had some gift cards they were dying to use.

So what did all 3 of them buy? Out of all the cool stuff at Humungous Toys? Video games? Some awesome electronic flame-throwing robot dinosaur? A really cool Lego set?

Nope. They each wanted a "Perfect Petzzz".

For those of you unfamiliar with this remarkable use of technology, it looks like a sleeping dog or cat. And all it does is "breathe". The abdomen repeatedly deflects in and out by a 1/4 inch to give this amazing impression.

Let's watch!





Impressive, huh? Exciting beyond words, right? What else does it do, you ask?

THAT'S ALL.

It's fixed in that position. The limbs don't move. The eye's don't open. And, under the fake fur, it's hard as a rock. Seriously. You can hammer nails with it.

It looks like it's breathing, but when you pick it up your first impression is that it's in rigor mortis.

Visually, it's cute for all of 5 seconds. And when you find out that the pseudo-breathing is all it does (until the battery runs out) you're absolutely shocked to find your kids got suckered into paying $29.95 for this thing.

And I'm not gonna criticize it anymore, because I can't. Somebody is getting rich off this stupid idea, and I'm on call trying to make a buck. They're obviously WAY ahead of me in laughing all the way to the bank.

Difficult Case

Okay, all you armchair neurologists, I'm on call this weekend, and it's time for you to help me with DR. GRUMPY'S CHALLENGING PATIENT.

Here's the story:

Mrs. Smith was mugged outside Local Mall yesterday, in an event witnessed by several bystanders. Mr. Scumbag hit her over the head with a crowbar (she'll be fine, don't worry) knocking her out, and grabbing her purse (he's already been caught).

So she was admitted to Grumpy Hospital. And the admitting internist wrote in the chart:

"Neurology consult with Dr. Grumpy, to determine why patient lost conciousness."

This one has me stumped, so if any of you want to chip in ideas to help, I'd appreciate it.

Saturday, April 10, 2010

Is she a cat?

I'm on call, and reading another doctor's dictation:

"Family history: depression. The patient's mother committed suicide several times."

It's a guy thing

Memories of patients past...

I don't remember his name anymore. He'd had a massive stroke. Unable to speak. Came in completely comatose. He was in his late 70's.

He was there for a few days. Not a drop of sedation was given. He didn't wake up at all.

On day 2 of his stay, while the family was trying to make a decision, something went wrong with his foley (bladder) catheter. So the nurse had to change it. I was in the room looking at the chart when they started to pull it out.

He yelled, quite clearly, "SHIT!!! MY DICK!!!"

The nurse stopped. He was again completely comatose. I did every trick in the book to try and get him to speak again. Nothing worked. The nurse pulled out the foley, and put a new one in. No repeat performance.

He was there 3 more days before he died. He never said anything else. Every attempt by me and the nurses to try and find conciousness again failed.

To this day I have no idea how he did it. The MRI was awful looking. I can only assume it's some primordial part of the Y chromosome. No matter how badly damaged the upstairs is, you're still touchy about the downstairs.

Friday, April 9, 2010

My 10:00

Showed up 10 minutes late.

Left his insurance card and wallet at his girlfriend's.

Forgot to bring in his MRI reports ("Oh, yeah, I think they're in a box under my bed.")

Had to call his mother to ask what medications he takes.

Forgot to stop at his regular doctor's office to pick up his insurance authorization.

And is wearing a T-shirt that says "I believe in personal responsibility"

Early Morning ICU Rounds

Attention guys:

Having a stomach tattoo that says "SUCK DIS, BITCH!" with an arrow pointing downwards WILL NOT endear you to the ICU nurses!

Thursday, April 8, 2010

Who's counting?

Mrs. Age: "My oldest sister turns 101 next week."

Dr. Grumpy: "Wow! Are you guys having a party for her?"

Mrs. Age: "Of course not. She died in '98."




15% off lab coats with code "labs_sale"

Whoa, Nelly!

From another doctor's hospital dictation, listing the patient's pulse:




For my non-medical readers, a normal adult resting heart rate is 60-100. the above (I hope) is a typo.

The last patient of the day

Following a whine session yesterday with Mary and Annie, I now present our list of issues that always seem to plague the last patient seen each day (especially when on a Friday).


The last patient of the day:

1. Shows up late, and wants to tell you the 10 minute story of why they're late. And/or wants to spend 10 minutes in the bathroom before the appointment starts.

2. Wants to read the required HIPAA privacy form word-for-word and ask questions, even though it's identical to the one every other doctor and hospital in the country use.

3. Has a new insurance card. And forgot to bring it.

4. Forgot to bring the insurance authorization for the visit, and the doctor who issued it closed earlier in the day.

5. Left their (MRI reports/lab reports/small child) in the car, and and has to go back to get them, and has no fucking idea where they parked.

6. Doesn't want to start the appointment until their spouse/child/parent arrives, and has no idea where they are. Or what their cell phone number is.

7. Has a new address, and needs to fill out the forms for it.

8. Needs a shitload of tests ordered.

9. Needs a bunch of prescriptions written, with both 30-day (local pharmacy) and 90-day (mail-in) scripts written for every damn drug.

10. Makes all who have contact with them want to strangle them.

Wednesday, April 7, 2010

No, just pick somebody else's family. It's more fun.

Dr. Grumpy: "Any major illnesses in the family?"

Mr. Gene: "You mean my family?"

Tuesday night, 9:25 p.m.

"Hi, I have an appointment with Dr. Grumpy tomorrow at 11:15, and I need to know if that's 11:15 our time? Or is that 11:15 in another time zone? I really want to be there, so need to know if it's local time or not. Thank you."

Tuesday, April 6, 2010

Annie's Desk, April 6, 2010

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

Mrs. Ditz: "My husband is having problems with his medication."

Annie: "Which medication is that?"

Mrs. Ditz: "The one Dr. Grumpy gives him. I don't know the name. He takes it at night."

Annie: "Okay, I'll look it up... What kind of problem is he having?"

Mrs. Ditz: "He says it causes side effects."

Annie: "What kind of side effects?"

Mrs. Ditz: "I don't know. What kind of side effects can it cause?"

Annie: "It depends on what he's taking."

Mrs. Ditz: "I don't know what it is."

Annie: "Why don't you let me talk to your husband?"

Mrs. Ditz: "He's at work. He won't be home until after 6:00."

Annie: "Why isn't he calling himself?"

Mrs. Ditz: "He doesn't know I'm calling. I thought it would save time if I did."

Dear Dr. Astute,

Thank you for seeing my patient, Mrs. Complex. She's a very challenging case, and I'm glad you were willing to provide your expertise.

And you certainly didn't disappoint.

Your impression of her condition, with all of it's details, showed such remarkable deductive reasoning and was so brilliantly detailed, that I realize there was no way I'd ever have come to such a conclusion.





Yes, folks. That's the entirety of his impression and plan. The only thing I took out is the good doctor's name.

Monday, April 5, 2010

Frazzled Farmacy

I had to stop at Local Pharmacy tonight to pick up a Sarcasma prescription for Frank (yes, now my kid is on it, too).


Pharmacy guy: "What's the name?"

Dr. Grumpy: "My son, Frank Grumpy."

Pharmacy guy: "Hang on... Here we are. Okay, has your kid ever taken Flagyl before?"

Dr. Grumpy: "No, but it's not Flagyl, it's Sarcasma."

Pharmacy guy: "No, it's Flagyl, I have it here, and it looks like there's another script for birth control pills. Has she ever been on those, either?"

Dr. Grumpy: "You've got the wrong script."

Pharmacy guy: "Well, it has her name on it."

Dr. Grumpy: "HE! The name is Frank Grumpy!"

Pharmacy: "Wait a sec... Oh, sorry. These are for Fran Grumpay, just sounded alike."


For those of you who didn't see the prescription drug that keeps me under control the last time I put it up...

(click to enlarge)

Tourism 101

Dr. Grumpy: "It's good to see you back. How was your adventure cruise to Antarctica?"

Mrs. South: "It was incredible! Oh my God! Did you know they have Penguins there? Like LOTS of them? It's unbelievable! More than they have at Seaworld!"

Early Monday morning

It was a quiet, relaxing weekend at the Grumpy house. A family gathering. Wii and boardgames with kids. Hot tub. Only one hospital call.

Somehow this always leads me to hope that the office week will start right.

Keep dreaming.

Grabbing my morning pills out of the medicine cabinet and heading for my car, I accidentally chewed through a fish oil capsule, slathering my freshly brushed teeth with the enticing taste of raw cod liver.

I slugged down a Diet Coke on the drive in, which improved things somewhat. I figured making tea would help further.

I keep a bottle of lemon juice at the office, and add a few drops to my water when I make tea.

After I pulled my water out of the microwave, I tossed in some sweetener and a tea bag, and took a gulp a few minutes later. And gagged.

I'd forgotten the water and just microwaved a big mug of straight lemon juice.

It sure as hell covered up the fish oil.

I think I'll stick with another Diet Coke for the time being. And hope like hell there's not a finger or something gross in the can.

Sunday, April 4, 2010

I'm old

Marie comes running into my office, dancing wildly with her portable radio. She's crazy with excitement.

"Daddy! Daddy! Listen to this awesome dancing song! It's new! I've never heard it before!"

She jabs an earbud into my right ear.

It was "I Ran".

By A Flock of Seagulls.

From 1982.

Nothing makes you feel older than your kids.

Sunday afternoon, 12:48 p.m.

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

Mrs. Manana: "Yeah, I have an appointment tomorrow, and need to come in today, instead."

Dr. Grumpy: "Today is Sunday. My office is closed."

Mrs. Manana: "Yeah, my appointment is tomorrow. But I just found out I have to work. Can I meet you there today?"

Dr. Grumpy: "No." (looks up schedule) "What about Tuesday or Wednesday, instead? Same time."

Mrs. Manana: "Do you see patients those days?"

Dr. Grumpy: "Um, yes."

Mrs. Manana: "Okay. I'll be in Wednesday."

Sunday Editorial

Quite a few readers have written in asking what I think of the Florida doctor who's told patients that voted for Obama to go find another doctor.

I'm sure it's legal. It's his practice. He can do what he wants.

But I don't think it's professional.

Part of being a doctor means treating people equally. Regardless of who they are. White or black, men or women, gay or straight, Republican or Democrat, Coke or Pepsi.

I don't discuss politics with patients. They ask me what I think of the new health care bill, and I give them a generic "We'll see what happens." Divisive discussions aren't good for a doctor-patient relationship.

Some people can be quite outspoken in their beliefs. I've taken care of a variety of ideologies. White supremacists. American neo-nazis. Socialists. Communists. Right, left, and in-between.

Sometimes it's hard to separate personal dislike from clinical judgment. But I do it, and try my best to treat all equally. And I never discuss my opinions with them.

"Dammit, Jim! I'm a Doctor!"

I am a person. With my own political beliefs. But there's no room for them in medicine. My job is to take care of people, and try to make them better, regardless of what I may think of them.

When President Reagan was shot, he famously quipped "I hope you guys are Republicans" to the surgical team as they were getting ready to operate on him, and the surgeon replied "We're all Republicans today."

Dr. Samuel Mudd went to jail for setting John Booth's broken leg after Booth shot President Lincoln.

The same trauma hospital in Dallas that frantically tried to save President Kennedy after he was shot, worked to save the life of his assassin, Lee Oswald, a few days later.

Caring for people equally, regardless of our personal thoughts about them, is what we do.

And if you don't think you can live up to that, then maybe you should find another profession.

Friday, April 2, 2010

Stupid

Mrs. Old has numb feet. She lives in a nursing home. I've never seen her before.

Today her new nursing home doctor was rounding on her. He saw in her chart that she's had numb feet for over 10 years, but has never seen a neurologist for them. She also has Alzheimer's disease, so can't tell him much.

At 10:45 this morning Dr. Newbie called my office to see if I would see her. Because of transportation issues, they couldn't get her here until next Thursday. So he didn't make an appointment for her.

At 1:45 the hospital called me. Dr. Newbie actually admitted her for 10 years of foot numbness and 5 years of Alzheimer's disease, so she could see me before next Thursday.

I refused the consult. I am NOT going to be a party to such an insane waste of money.

What the hell?

Quitting smoking

Dr. Grumpy: "How are you doing with quitting smoking?"

Mr. Inchworm: "Better. I'm down to 1.25 inches."

Dr. Grumpy: "Inches?"

Mr. Inchworm: "Yes. I have 10 cigs a day. And I measure them past the filter, and cut them off at 1.25 inches."

Dr. Grumpy: "That's not the most common way of quitting."

Mr. Inchworm: "Last week it was 1.5 inches, and next week I'll go to 1 inch."

Dr. Grumpy: "Do you think this is going to work?"

Mr. Inchworm: "Of course! I use a ruler and everything."

Statistics R Us

Doing a research survey this morning. It featured this question:

"What percentage of your migraine patients suffer from migraines? Your answers should add up to 100%."

Thursday, April 1, 2010

My readers write

I'd like to thank my reader Amy, who sent this earlier:

Dr. Grumpy,

I am a faithful reader who checks in a couple times a day, and often I am shaking my head at the antics of your patients. Like others, I wonder sometimes if you write it up for the purposes of humor, because can people really be that idiotic?

This morning, I went to the doctors office early to have my fasting blood work drawn for an annual physical. My internist is in a large medical building with several practices on two floors. I overheard an older man say to the receptionist: "I have an appointment, but I'm not sure who it's with. I don't know the doctor's name or what it's for, but my appointment is at 8am this morning."

Dr. Grumpy, I now believe every word you write, verbatim.

Thank you for your great blog.

Amy


You're quite welcome, Amy. Thank you guys for reading it!

I refer you to the crazy patient scale, which I posted last Summer. To give credit, it was written by ER's Mom. And I thought it was just awesome.


Levels of Patient Crazy

1. Normal. They exist, even constitute the majority of patients. They make poor blog fodder, however, so you wouldn't know that that they even exist from reading any medical blog.

2. Crazy. These are the "fun crazy" folks. A little off, but you don't cringe when you see them on the schedule.

3. Bat-shit crazy. Your stomach drops a little when you see the name on the schedule.

4. Fucking Nuts. These folks seem intent on driving YOU nuts too.

5. Mouth agape and head shaking. You are lost for words upon meeting these folks. Fortunately, they are rare.

Guessing games

Dr. Grumpy: "Your blood pressure is 148/80. Where does it usually run?"

Mrs. Sphyg: "Oh, in the upper-higher, lower range."

Dr. Grumpy: "What do you mean by that?"

Mrs. Sphyg: "You know, where the upper number is higher than the bottom number."

Why I do what I do

It ain't much to look at.

Two, maybe three pounds of grayish-white goop. It's not even solid in a living person. More like Jello that floats around in it's vault.

But it's amazing. From that sloppy goop has come remarkable stuff. It's sent a robot to land on a moon of Saturn. It's explored the bottom of our deepest oceans. Built the Taj Mahal. The Great Wall of China. Painted the Mona Lisa.

Go listen to the remarkable Bach's "Toccata and Fugue in D minor". Not just the famous opening 30 seconds or so, but the whole 9-10 minute thing. That all came from the goop, long before it was heard or played on an instrument, it was just a series of electric signals jumping from nerve to nerve. The piece is over 300 years old. The mind that created it has been dead for over 250 years. And humans will likely be listening to it long after my great-great-great-grandchildren are dust.

The soul is there. The heart is amazing, but for all our romantic beliefs about it, who we really are is floating around in the goop. It's where hate, love, and everything in between comes from.

It's capable of terrible evil, such as the Holocaust, and remarkable good. Look at the outpouring of altruism that follows disasters. I love my dogs, but if something bad happens to a dog on the next street, they're not going to care. Yet the goop wants to help people who we've never met and have no direct impact on our own lives

My regular readers know I'm interested in maritime history. Why? I have no idea. It's just been a subject I've loved as long as I can remember. I've never been in the navy. The family military history consists of grandparents who served in the army, but never were sent overseas. I can only assume there is some particular molecular structure in my goop that makes me interested in it. Or that made me want to treat other people's goop for a living.

Twin and biological studies have shown that most of who we are is how we came here. Yes, life experiences and background count for something, but the goop is most of it. People with conservative beliefs raise kids who turn out to be liberals, and vice versa, no matter how hard they may try to pass on their beliefs.

Coke vs. Pepsi. Dogs vs. Cats. Mac vs. Windows. I suspect whatever makes us fall on one side or the other of these great philosophical issues is 95% or more in the goop, and we just come that way.

Everything you are, have been, and will be. Have desired, dreamed of, and done. Have felt. It all comes from a few pounds of goop.

And this fascinates me. Because, let's face it, we're just another part of the planet. A collection of complex molecules, electrical impulses, and chemical reactions. That's all people. Anatomically, all humans are pretty much the same. And we're not that different from other mammals. The difference in our genetic sequence vs. that of a mouse ain't much.

And yet that small amount of difference has led to amazing results. The ability to think beyond our own biological needs and to see the world around us for the beauty it contains. To watch a sunset and be in awe, even though we understand the science behind it. And to look up at the night sky, and wonder.

And that never bores me.

Wednesday, March 31, 2010

My Reederz Rite

I'd like to thank my reader Beverley, who sent this picture. She says it was in the window of a Tesco supermarket in the U.K.


Another fine patient quote

"It's such an unexplainable thing, because, you know, I can't explain it. It's like something that is totally, entirely, not explainable, because no matter how much I try to explain it, it's still unexplainable. Does that explain it?"

Dear Mag Mutual Healthcare,

Thank you for your catalog of spiral-bound medical coding notebooks.

I've been trying to save money. But when I saw that if I spend only $355.95 on your books, I get a FREE stuffed bear (I bet it's made in China, and only cost you a few pennies), I just KNEW I had to place an order. A deal on a FREE stuffed toy like that (with every order of $355.95) doesn't come along every day.





If I had any second thoughts about getting the books, they were immediately erased when I noticed Jennifer on your cover (with the bear in the background).





I'll call you to place my order later, Jenn. I just hope Mrs. Grumpy doesn't catch me.

Tuesday, March 30, 2010

Mary's Desk, March 30, 2010

(Lady in scrubs comes in, stands at the front counter)

Mary: "Hi! Can I help you?"

Ms. Tooth: "Hi! I'm Cindy Tooth! I work for Dr. Plaque, the dentist across the street, and we're doing free tooth whitening for all medical office staff, to get them familiar with the procedure."

Mary: "Oh, that's nice, but no, thank you."

Ms. Tooth: "Are you sure? It looks like you could use it."

Mary: "Get out."

Early morning at the office

Dr. Grumpy: "Did you call her back last night?"

Annie: "No. I'll do it this morning. I couldn't bear to do it at the end of the day. She's like a torture chamber with a mouth."

Monday, March 29, 2010

Gee, thanks

More grainy, faxed pictures from a GI doc of the inside of my patient's rectum. This will really help me treat his Parkinson's disease.



Dude, you're also a pig

Look, I think it's great that you, a busy man in his 50's, would take the time out of your day to bring your mom to her appointment.

And I don't mind (too much) that you farted, loudly, in my office. I'd rather you have done it elsewhere, but sometimes we can't help it.

But, in all honesty, you then smiling and saying "Boy, that felt good!" wasn't needed. At all. I am not one of your beer buddies, and we are not in your living room.

Dude, you're a pig

Us guys get a bad rap. And, in all honesty, we at least partially deserve it. I myself am recently guilty of selective hearing.

There are times, however, when I encounter a situation that makes me ashamed to be a carrier for the Y chromosome (like this, from last year).

Yesterday I had a consult on a 24 year old lady who'd been admitted for some pretty scary symptoms. I got to the floor while she was downstairs having an MRI, so I saw a few other patients while waiting for her to come back.

Her boyfriend showed up during this time, discovered she wasn't in the room, and made himself comfortable. He adjusted the bed to a cozy position, bought a bunch of chips and pop from the vending machines, stretched out, and turned on basketball.

After about an hour she was done with the MRI, but there wasn't anyone available to bring her back to the room. Since I wanted to get started on the consult, I went downstairs myself, put her in a wheelchair, and pushed her up to the room.

When I wheeled her in, I looked at Mr. Boyfriend, and said, "You'll have to move to the chair. I need to examine her, and she needs to be in the bed."

He didn't budge. Without looking away from the screen he said, "Dude, I'm watching the game."

Sunday, March 28, 2010

Comedy on rounds

I'm evaluating a pleasant, but very forgetful, older gentleman. His family is in the room.

Doctor Grumpy: "He seems to be very forgetful. Is he demented?"

Wife: "Heavens no!"

Daughter: "Oh my God! Is he ever!"

Son: "Maybe just a little."

Patient: "What's demented?"

Sunday morning rounds

Looking through the chart on a new consult. 22 year old female, who suffered a concussion yesterday.

I went in to see her. She had a HUGE bruise on her forehead, a few stitches at the hairline, and looked vague familiar.

Dr. Grumpy: "What happened?"

Miss Concussion: "I was upstairs doing a student nursing rotation yesterday, and had begun throwing up after seeing a lot of blood, when I got really lightheaded and remember falling toward the sink..."

Saturday, March 27, 2010

Career change time?

On call today, there was a batch of young student nurses (maybe they were student nurse aids) at the hospital.

I was sitting at a nurses station, when a patient call light went on. One of the nurses, who was filling out forms at a desk, glanced up at a student and said "Hey, can you please see what he wants?"

The student went into the room, and we heard this:

Student: "What can I do for you... OHMYGOD!!!"

Patient: "Sorry, it looks like I'm bleeding a little and..."

Student: "A LITTLE! HOLY HELL! NURSE!"

The student ran out of the room and into the bathroom across the hall.

The nurse went into the room, giggling.

The patient began laughing.

On call. And they do call.

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

Miss Myelin: "Yeah, I see Dr. Cortex for my MS, and I woke up today with blurry vision, and I can barely walk."

Dr. Grumpy: "Have you had this before?"

Miss Myelin: "No, it's new. When my MS acts up Dr. Cortex usually admits me to the hospital for IV steroids."

Dr. Grumpy: "That's standard. I think you need to go to ER, and I'll likely admit you."

Miss Myelin: "Are you kidding? I don't have time for that shit."

Dr. Grumpy: "Excuse me?"

Miss Myelin "I don't have time for that. Can I schedule them for next week, like Wednesday or Thursday?"

Dr. Grumpy: "I suppose, but you'll have to call Dr. Cortex on Monday and... Look, if you're not going to let me help you, why did you even call on the weekend, anyway?"

Miss. Myelin: "Because I thought it might need urgent treatment."

Friday, March 26, 2010

Insanity

A grateful patient brought me a box of chocolates yesterday. So I took it home to share with my kids.

I got home, and they were all excited. You'd think they'd never seen freakin' chocolates before.

I opened the box, and they all peered in. I said they could each take one.

And immediately, a fight broke out.

Did they fight over who got the first candy? No.

Did they fight over who got which candy? No.

They fought over who got the bubble-wrap packaging.

Do you need a prescription for that?

Dr. Grumpy: "Do you take any other medications?"

Mr. Nike: "Umm... I like jogging."

Thursday, March 25, 2010

I'm going to change my undies now

I'm with a patient. My cell phone rings. It's the most dreaded caller ID of all: Mrs. Grumpy.


Dr. Grumpy: "Hello?"

Mrs. Grumpy: "Hey, can you pick up Craig on the way home? He's at the police station."

Dr. Grumpy: "OMG! WHAT HAPPENED?!!!"

Mrs. Grumpy: "Nothing. The Boy Scouts are touring it today. I told you that last night."

(long pause)

Dr. Grumpy: "Yes. I knew that."

Mrs. Grumpy: "Idiot."

I'm not that crazy. Yet.

Like most doctors, we have a sign-in sheet. It's not much, people just write their names and the time they arrived.

Mary usually tosses the old one and puts out a new sheet for the next day when she leaves at night, but forgot to yesterday.

So today's first patient comes in, and looks at this long sign-in list of patients seen between 8:00 and 5:00. And she looks at Mary and says "Oh, I had no idea you guys were working night hours now. That would be better for my schedule, too."

Wednesday, March 24, 2010

Bon voyage

The following message was left on my office voice mail over lunch hour:

"Hi! This is Cindy Scatterbrain! I forgot to call you guys last week, but I'm leaving for France tonight on a 3 month exchange program and so I'll need 3 months of my epilepsy medicine, whatever it's called. Can you guys call that in to my pharmacy ASAP? Or, I'll be near your office later today so do you have 3 months of samples I could pick up? Or if you can't do that, do you guys know a pharmacy in France you could call it to and I'll pick it up when I get there? Thank you!"

Early Wednesday Rounds

I was at the hospital this morning, seeing a new stroke patient.

The head CT was read as normal yesterday afternoon, but when I looked at it I thought there was a stroke on the left side. And I didn't trust the person who'd read it, so I called the night radiologist (who I do trust).

Dr. Radar: "Night desk."

Dr. Grumpy: "Hey, it's Grumpy. I'm looking at the head CT on Mrs. Stroke. It was read yesterday as normal, but I think there's a stroke on the left."

Dr. Radar: "Hang on... No, that's not a stroke. If you look at the other images, it's just artifact."

Dr. Grumpy: "Are you sure? It really looks like a stroke to me."

Dr. Radar: "Positive. Definitely artifact."


I disagreed, but it's his specialty, and I respect him. I got off the phone and began writing my note. About a minute later a nurse came over to say Dr. Radar had called back looking for me.


Dr. Grumpy: "Grumpy."

Dr. Radar: "Yeah, it's Radar again. Did you say the thing on the right or the left?"

Dr. Grumpy: "Left".

Dr. Radar: "Sorry, I thought you said right. Oh yeah, that's definitely a stroke on the left."

Tuesday, March 23, 2010

Foot, meet mouth

Mrs. Sadd: "I'm sorry I'm late, my husband and I just got back from Hawaii last night."

Dr. Grumpy: "Awesome! That's a fun trip! What did you guys do while you were there?"

Mrs. Sadd: "We went to my father's funeral."

Think green

I was out of syringes and needles, so I ordered some.

They came in cardboard boxes that said "Made from recycled materials."

I really hope they mean the boxes...

Wow! What a great policy!

I noticed this authorization in a patient's chart yesterday. Isn't it awesome?

The patient is only 44, and yet his insurance has been covering him for over 110 years, just waiting for his visit with me earlier this year.


(click to enlarge)


 
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