Monday, October 11, 2010

Childhood Lesson FAIL!

When I was a kid, which was a while back, I was told to never put a plastic bag on my head. Otherwise I might suffocate.

And every bit of plastic wrapping you find today usually has a "keep away from children due to risk of suffocation" label.

But apparently, such a critical warning didn't get to everyone. Like a guy who recently tried to rob a store, and somehow ended up nearly asphyxiating himself.

Here's the article.

Thank you to my reader Sarah for sending this in.

When hospital rounds go bad

Early this morning I went to the hospital to check on Mrs. Tinystroke. She'd been doing much better last evening, so my plan was to get her home today.

I walked in the room to see two nurses standing by the bed. Mrs. Tinystroke looked awful. Unconscious, limp, drooling and very pale.

Dr. Grumpy: "What happened? When did this start?!!!"

Nurse Nightshift: "She's been like this all night."

Dr. Grumpy: "WHAT! Why didn't anyone call me!"

Nurse Nightshift: "Because..."

Dr. Grumpy: "This is unbelievable! My patient burns down overnight and you guys don't think to call me? Holy crap! I need a STAT head CT and..."

Nurse Nightshift: "DOCTOR GRUMPY!!!"

Dr. Grumpy: "What? I don't want some lame excuse..."

Nurse Nightshift: "LOOK! The reason I didn't call you is because THIS ISN'T YOUR PATIENT!!!" Mrs. Tinystroke is in room 17. You're in 16."

(long pause)

Dr. Grumpy: "These gray heads are all starting to look alike."

Nurse Nightshift: "Yes, and you're giving both of us one."

(another pause)

Mrs. Tinystroke: "Dr. Grumpy, is that you out in the hall? Can I go home today?"

Sunday, October 10, 2010

More Important Research




Want to avoid bar fights? Don't go to bars frequented by heavy drinkers with a history of violence!

You didn't know this already?

Well, SOMEBODY had to research such an important issue. So from 1997 to 2002 somebody did just that. And found that bar fights tend to occur in places that are poorly lighted, dirty, and crowded, with patrons that are younger, angrier, impulsive, less considerate, and heavy drinkers.

They also found that women who get in bar fights have had 4 times as many drinks on those nights as they normally do (normal presumably meaning non-bar-fighting nights).

Here's the abstract for the main article. The complete article can be found in the Journal of Studies on Alcohol (which rejected my 1988 submission on cow-tipping).

They actually got 2 articles out of this, with this one focusing just on women. The second article was published in Aggressive Behavior (they're coming to my house next week to see if siblings fight).


Thank you to JoAnna for bringing such important research to my attention.

Saturday, October 9, 2010

Attention mean commentors!

Now here's a lady who takes her blog seriously. Briana Greathouse.

She was so upset over internet postings that she went on a 4 hour road trip, with her gun, to kill a man who she felt had said mean things about her online. Fortunately, she was picked-up before she could hurt anyone.

Here's the original story.


I don't have such a lenient policy as she does. You piss me off, and I'm leaving my kids at your house.

Thank you, Tabby, for sending this in.

Mooooooooooo!

I'd like to thank my reader Salma for submitting this fascinating research that affects all of us. Namely, scientific data on the physics of cow-tipping.

The study suggests that cow-tipping is very difficult, if not physically impossible, for the majority of attempts.

I now feel vindicated, as I personally researched this subject in one occasion in the late 80's (Grumpy, I., et al. "Why the hell is it still standing?", Journal of Inebriated Nights Spent at a Camp in the Middle of Fucking Nowhere, 1988), with similar results.



Boffins debunk cow-tipping myth

Not possible, even when drunk

By Lester Haines
9th November 2005

Two scientists at the University of British Columbia have rather disagreeably debunked the myth that you can - when suitably refreshed after a night on the sauce - stagger into a field and tip over a sleeping cow.

According to the Times, Margo Lillie, a doctor of zoology, and her student Tracy Boechler did a few calculations pertaining to bovine bothering and concluded that it would in fact take five sozzled pranksters to tip a cow.

More specifically, "a cow of 1.45 metres in height pushed at an angle of 23.4 degrees relative to the ground would require 2,910 Newtons of force, equivalent to 4.43 people," according to Boechler.

To read the complete article, click here.

Friday, October 8, 2010

Idiots

Today it POURED here in Grumpyville. But my car was running low, so on the way home I pulled into a gas station to fill-up.

It was one of those places that has an automatic car wash, where you can pay at the pump for a wash, then drive through the thing.

So guess what? In FREAKIN' POURING RAIN I saw 3-5 cars go into the car wash, get cleaned up, THEN DRIVE BACK OUT INTO THE DOWNPOUR and go on their merry way.

Seriously. WTF people?

Do you hear what I hear?

Dear CNN,

I usually skim your web page a few times a day, and noticed your health headline yesterday on "Secrets you shouldn't keep from your OB/GYN". Since I personally don't need the services of an OB/GYN, however, I didn't read it.

This, as my reader Webhill later pointed out to me, was a serious mistake.

Most of the article was fairly helpful, inoffensive, medical info. But it was the last paragraph that got Webhill's (and my) attention.

Quoting Dr. Lissa Rankin (OB/GYN): "When a woman comes into my office, we sit on two red leather chairs across from each other. I give them a hug. I offer them a cup of tea. I ask them, 'if your vagina had a voice, what would it say?' "

WOW!

I've been a neurologist for quite a few years, but it's NEVER occurred to me to ask what a brain, spinal cord, or carpal tunnel would say. Maybe I'm just being remiss. I've never offered patients tea, either, and I don't have leather chairs.

Talking vaginas are nothing new. The movie "Chatterbox" (1977, starring Candy Rialson) was (I swear!) based on the premise of a woman with a talking vagina. The vagina was talented and went on to a singing career (REALLY!). It was sort of "Deep Throat" in reverse (uh, um, I mean, that's what I've heard).





But back to your topic. I took an informal poll of women I know, and posed the same question. I received several answers:

"It says it wished it hadn't pushed out four kids. C-sections are starting to look better and better as I sag."

"No more fucking pantyhose! I need some air!"

"Eat me!"

"It would say you are a whack job, please forward a copy of my records to my home address at your earliest convenience."

"Hello?!!! Why the hell are you talking to a vagina?"





Another point that a (unidentified) member of Dr. Pissy's staff made: "You know the tiny little cover-nothing-but-a-few-pubes paper things that we have to put on at the GYN? They don't cover your butt AT ALL. So if I'm sitting bare-assed on a leather chair, MY vagina is going to ask if the chair gets sanitized between patients."

I think this is also something a female doctor could get away with, that a guy couldn't (which is interesting, because you interviewed a female doc, but had a picture of a male one). Let's face it: Take away the medical atmosphere, and you've got 2 people in leather seats who've just hugged, one has bought the other a drink, and now wants to talk to the others genitals.

Obviously, I don't have a vagina. But, let's say I went to a doctor: He puts me in a comfy chair, offers me a Diet Coke, tries to hug me (I don't think that's going to happen) and then says, "So, Ibee, if your penis could talk, what would it say?" (Does that sound like a pick-up line from a gay bar?).

My mouth (not my winkie) would likely say "Get away from me!" grab my pants, and be grateful he hadn't gotten to the turn-your-head-and-cough part. Tell me this- if a male urologist asked guys that, would you feature it in an article about good medical practice?

I have nothing against Dr. Rankin. I'm sure she's an excellent physician, with far better taste in office furnishings and beverages than me (the red leather chairs, by the way can be seen on her blog. It's called "owningpink.com". Honest!). But I personally would be a little skittish of doctors wanting to have a conversation with my nether regions.

Yours truly,

Ibee Grumpy, M.D.

Thursday, October 7, 2010

Things that make me grumpy

Dear Dr. Irritating,

I'm just writing to let you know that there is NO cure for Alzheimer's disease. There are some marginally effective treatments to slow it down a bit, but NOTHING that cures it.

I thought you knew this, but obviously you have no freaking clue. Or are just stupid. Or ignorant. Or don't care. Or believe whatever the pfarmaceutical reps tell you.

Patients and families say funny things, and sometimes hear only what they want. So if one makes an odd comment about you, I tend to ignore it. But when I start hearing it from others, and see a trend, then I think differently.

I treat patients to the best of my ability with what I have. In the case of Alzheimer's disease, it isn't much. They all get worse. I tell families that in advance, because reasonable expectations help all of us.

What doesn't help is YOU. Several families have told me that when they say the memory is getting worse, you immediately tell them to return to me "so he can do something about it."

And then, yesterday, a referral from your office showed up on my fax. You'd written: "Please refer back to Dr. Grumpy for Alzheimers. His treatment isn't working, as she keeps getting worse. Needs to change meds to get her better."

I know your handwriting. Now you can't blame your ignorance/stupidity on anyone else.

Being realistic with patients and families is the best treatment for anything. No matter how many times I see them, there are limits to what I can do. But at least I can do better than you in telling them the truth.

Yours truly,

Ibee Grumpy, M.D.

Wednesday, October 6, 2010

Loose associations

Dr. Grumpy: "Okay, I'd like to start you on Lyrica..."

Mr. Goofball: "Oh, no. That drug doesn't work for me."

Dr. Grumpy: "I didn't know you'd taken it before?"

Mr. Goofball: "I haven't, but it gave my cousin's buddy a stomach ache."

I prefer to check the old fashioned way, thank you

Yesterday Local Radiology Place brought lunch. I wanted to hear about their new MRI, but the sales rep was determined to give Dr. Pissy and I her complete sales pitch about everything. Of course, that covers a lot, so she was talking incredibly fast. At one point she threw out this line:

"Doctors, our new digital mammogram system is extremely accurate at determining the presence or absence of breasts, and is faster than previous methods of doing so."

Tuesday, October 5, 2010

Concerned children

I picked up the kids from school and headed home.

Dr. Grumpy: "Okay, gang, listen up. Mom had to go home sick from work today, and is not feeling well. So when we get home, she's probably in bed. I want you guys to be VERY quiet when we go in the house."

(long pause)

Craig: "Dad, I have a question."

Dr. Grumpy: "What's up?"

Craig: "So Mom is already at home?"

Dr. Grumpy: "Yes."

Craig: "Then can I get my potato chips out of her car?"

Lost in translation

Yesterday I saw a nice lady, who spoke reasonably good English, but her primary language was French.

So she was accompanied by her niece, who said she was here to translate.

I only speak English. And guess what? So does the niece!

Her idea of "translating" was like the old SNL "News for the Deaf" skit. Like this:

Dr. Grumpy: "Where is the pain?"

Ms. Niece: (pulling on patient's sleeve and shouting in her ear) "THE DOCTOR WANTS TO KNOW WHERE YOUR PAIN IS?!!!"

This went on for an hour. The patient spoke good English, and could hear perfectly well. By the end of the appointment I think we were both ready to strangle the niece.

Monday, October 4, 2010

Sorry, dude

I hear some great excuses, and Mrs. Grumpy hears more. Some are less believable than others.

But, look dude, if you're in a car by yourself, AND the cops find a bag of cocaine crammed in your butt, it's really not going to fly to claim it ain't yours.

Like this guy.

I'd like to thank my reader Lee for submitting this.

Get down! Get funky! Get green!

I'd like to thank The Mother for sending this in.

Yes, the economy is getting better, but I think we're all looking for ways to save money. Of course, we all want to be environmentally conscious, too.

So here's a truly heartwarming (or whatever you're warming) story of how a brothel is giving clients who ride a bike there a discount. Isn't that nice?

To read the article, click here.

Nice job, ad agency

While catching up on journals this weekend I found this ad, featuring a June Cleaver (ideal American mom, circa 1950's) knock-off. To me, it seems June is unlikely (not impossible, but unlikely) to be this guy's mother. But hey, that's just me.

(click to enlarge)


Sunday, October 3, 2010

The aliens have landed!

Our house has white carpet everywhere. We didn't pick it out, it was that way when we bought it. So, with 3 kids and 3 dogs, it's gradually become more of a tan color, with spots of varying origins.

But never fear, we have a Spotbot. The miracle of modern housecleaning that targets one small circular area with it's cleaning powers.

Yesterday, Mrs. Grumpy had a bunch of errands, and was gone most of the day. She asked if I'd do something about the large number of food/crayon/who-knows-what stains in one room.

So I got the Spotbot out and attacked the areas. I thought it went pretty well. It returned the stained area to their original whiteness, without too much work on my part.

Mrs. Grumpy got home, and was not as impressed with my work as I was. While she agreed that I had, indeed, done a good job of whitening the affected areas, she wasn't happy with the overall results.





I tried telling her that I took the kids to a movie, and that crop-circle making aliens had invaded and been working on a smaller scale in our home.

She didn't buy it.

Saturday, October 2, 2010

2010 Ig Nobel Prizes




Okay, Grumpyites. In the interest of science, I'm devoting today to the recent Ig Nobel prizes.

For those who don't know, the Ig Nobels are awarded to real research which is, um, more unusual than that typically considered for Nobel prizes.

If you missed the 2009 Ig Nobel awards, click here. They featured studies on the solidity of beer bottles vs. skulls, the ability to make diamonds from tequila, and a bra that could convert to a gas mask in an emergency.

The 2010 Ig Nobels included research on oral sex in bats, techniques for collecting boogers from whales using a remote-controlled helicopter, and a special award to British Petroleum for disproving the long held belief that "oil and water don't mix".

To read these, and many more, click here.

Thank you to everyone who sent in links for this.

Friday, October 1, 2010

Reasons I love my patients

Today a patient came in for the first time since she had a baby. We had this exchange:


Mrs. Kidz: "I've got a boy and a girl now, and I'm done."

Dr. Grumpy: "Did you get your tubes tied?"

Mrs Kidz: "That's what my OB did, but it's not exactly what I wanted. I'd specifically told him to tie my tubes, then crush and burn them, then use tractors to pull them as far apart as possible, and scatter the pieces to the 4 winds. But all he did was tie them."

I laughed VERY hard.

Did you bring a sleeping bag?

Guy comes in, stands at front desk.

Mary: "Hi, can I help you?"

Mr. Kampout: "Yeah, I have an appointment with Dr. Grumpy next week."

Mary: "Okay..."

Mr. Kampout: "Can I be seen today or tomorrow instead?"

Mary: "Let me see... No we're all filled up, but I can call you if someone cancels."

Mr. Kampout "Thank you. Can I wait here until then?"

Thursday, September 30, 2010

Dear Mr. Winkie,

I try to be prompt, and run my schedule on time. I really do. Most of my patients are used to that, but you're new to my practice.

So I understand you bringing something to read. People often do, as the assortment of People, Newsweek, Home & Garden, and other lobby magazines can be boring. So I see people with books, newspapers, knitting stuff, Nintendos, laptops, and such to pass the time.

But if you're going to bring something to your next visit, please DON'T make it another issue of Penthouse.

I've got nothing against porn specifically. If that floats your boat, more power to you. But reading it in my lobby, where one of my patients had her kids, didn't make for the calm and tranquil environment Dr. Pissy and I try to cultivate.

So next time, just stick with the Newsweek or Glamour* issues in my lobby.

Thank you.

(*we Seinfeld fans know who we are, huh?)

Yes, that's a very common disease

I was doing an online medical survey this morning, and encountered this question:

(click to enlarge)


Wednesday, September 29, 2010

Important safety measures

Mrs. Klumsy: "I used to fall when going down stairs, but I was able to stop that."

Dr. Grumpy: "How did you stop it?"

Mrs. Klumsy" "Now I only walk down them with my eyes open."

Detective work

Dr. Grumpy: "So what kind of symptoms are you having?"

Mr. Papyrus: "Didn't Dr. Imed send you a note?"

Dr. Grumpy: "No. Are you hurting somewhere?"

Mr. Papyrus: "Yes."

Dr. Grumpy: "Where are you hurting?"

Mr. Papyrus: "It said in his note."

Dr. Grumpy: "Okay, but where do YOU remember the pain being?"

Mr. Papyrus: "Wherever Dr. Imed told you it is."

Dr. Grumpy: "How long has it been hurting?"

Mr. Papyrus: "How long has what been hurting?"

(long pause)

Dr. Grumpy: "By any chance did Dr. Imed think you were having memory problems?"

Mr. Papyrus: "Maybe. That sounds familiar. Why? Did you find the note?"

Tuesday, September 28, 2010

Welcome to Grand Rounds, year 7!

As you're all aware, I was asked to host online Grand Rounds this week. So thank you all for coming! I'll be returning to my regularly scheduled whining tomorrow.

Coffee and bagels are in back. Sign in on the sheet. Medical students, please remember that you're allowed to sit ONLY if there are chairs left after the attendings, fellows, residents, and homeless people (here for the bagels) have been seated.

Food was provided by our drug rep Rikki, on behalf of Wirfliss Pharmaceuticals. She asks that when writing a prescription, please keep their many Wirfliss products in mind.

Before beginning, I'd like to thank Dr. Fizzy for her suggestions on doing grand rounds, and (as always) her totally awesome collection of medical cartoons. If you don't already read her, then (after this) click here and get started.

A big thank you to everyone who sent stuff in. I received A LOT of submissions, and unfortunately couldn't use them all. So if you didn't make it, I'm sorry. Everything I got was good. Some of you sent great anecdotes and stories, but in keeping with tradition, I limited it to links for blogs.

And we're off! The topic was: THINGS THAT MAKE ME GRUMPY!


To start, I present: THE PHARMACISTS!




The king of pissed-off pharmacists, The Angry Pharmacist, submitted this post about an issue that drives him (and many docs) nuts- the prevalence of meds ending in -XR, -XL, -CR, etc.

My esteemed colleague Pharmacy Chick sent her list of pet peeves from the other side of counter. And I have to agree with her.


Next up in the center ring: THE NURSES!





From the Florida keys, we have Mojito Girl. She brings us stories from the ER "spa" there. Mojito, dear, although your email promised "truckloads of money sent to a Swiss bank account" for putting this up, I still haven't received it. Perhaps this is because I don't have a Swiss account. Or simply the logistics of you driving trucks from Florida to Switzerland.

Nurse Running Princess (like many of us) finds herself stymied by some of the asinine ideas that drift down from hospital management.


Here they are: THE MEDICAL RECEPTIONISTS!





My idol, Dr. Oscar London, once wrote that "The doctor is your humble servant. The secretary is Her Majesty, the Queen", and I quite agree. You all know my boss secretary, Queen Mary, but she's far from alone in the combat of front desk medicine.

Queen Kate sent 4 totally awesome examples of the insanity that goes on in the trenches, and I couldn't pick one over the others (I tried). So here, in no particular order, they are:

Crayzee 1, Crayzee 2, Crayzee 3, and Crayzee 4.

I think if Mary and Kate start a blog together, they'll drive me off the web.


Next up: THE PARAMEDICS!





Medic999 had a lot to say about the insanity of an answering service that doesn't quite grasp what "the patient is dead!" means.


Now taking the stage: THE DOCTORS!





Dr. Orion, from the wild world of psychiatry, writes about misadventures on a book tour.

On the topic of false advertising, pathologist Gizabeth writes in about being promised a lab specimen of gangrenous hemorrhoids (doesn't that sound horrible?), and her disappointment when they weren't.

Doctor D gets peeved over patients who want a doctor to have superpowers to diagnose and treat without ever seeing them.

Jill-of-all-Trades, M.D. wanted to stress ways to avoid being grumpy (no, I don't understand that, either), and sent in tips to properly conduct the circus of medical practice.

Master Surgeon RLBates wrote in concerning a trend that makes her (and me, too) grumpy: A TV show that's promoting plastic surgery as a prize package for brides!

Manixter, an anesthesiologist who specializes in passing gas, writes in to tell us what it's like when you have to use bedside manner with a relative. She also had a Jeff Foxworthyesque piece on you may be an anesthesiologist if...

Dr. Kirsch, while not necessarily grumpy, sent in a poignant post on faith and medicine.

Glass Hospital sent in his secrets about working at a university student health center.

Dr. Dalai, a radiologist who specializes in the "I'm tearing my hairs out by the roots" field of IT, sends in his grumpiness over trying to set up a PACS system.


Entering the spotlight: THE RESIDENTS!





MD Resident, who's surviving the hazing ritual of call, wrote about annoying aspects of residency.


And now... THE MEDICAL STUDENTS!





Action Potential wanted to gripe about schools promoting "new curriculum" ideas that do nothing but make you look socially inept.

Mack wanted to grump about the serious medical condition Facebookalgia.


And last, but certainly not least,... THE PATIENTS!





The Banshee, who recently had a baby without any freakin' pain meds, sent in this story of a whiny family member.

Pink Tee Shirt sent in her peeves from the patient side of the medical world.

Copewithpain wanted to discuss problems encountered at the doctor's office.

Joseph Morris wanted to discuss disgusting things about public bathrooms.

While I, personally, revel in my grumpiness, the folks over at Bedside Manner wanted to suggest ways to avoid being Grumpy. Here are their suggestions, though they forgot to list "don't run out of Diet Coke."





It looks like we're running out of both time and bagels, so I'll wrap up. In closing, I'm going to post my own pick, something entirely unrelated, and one of the best pieces of blog writing EVER. Nurse Maha's awesome take on Edgar Allan Poe's classic poem, The Raven.

And that's all! Thanks for joining us for Grand Rounds. Let's have a round of applause for Nick Genes (no relation to Splice) and Val Jones for asking me to do this (I'm still waiting for my Diet Coke, by the way). Next week Grand Rounds will be held over at Sharp Brains, so tune in then.

Medical students, please don't put the leftover bagels in your white coats until the residents have picked them over.

Monday, September 27, 2010

Homework

Tonight Marie asked me to look over her math homework. It featured this:

Question: "Write a word subtraction problem using the numbers 18 and 10."

Under it Marie had written: "Frank had 18 words and gave 10 of them to Craig. Frank had 8 words left."

More Medical Research

I'd like to thank my reader PMH for submitting this.

I think we've all played beer pong. I mean, what would college be without it?

And most of us, especially shitty players like me, can attest that you can get pretty damn drunk playing it. Definitely more so than other drinking activities, such as watching football or flying a commercial plane.

So you can ask pretty much any college student "Hey! Do you get really drunk when playing beer pong?" And the answer will be "Yes!".

Of course, walking around a college campus and asking such questions, or simply hanging out in a bar and taking notes, are way too simple for your average researcher. So instead the folks at one university had to create a simulated model of beer pong using computer software. Really.

What did they learn?

That playing beer pong leads to increased alcohol consumption. Shocker, huh?

Here's the article.

September 27, 1854



After the war of 1812 , the United States and Great Britain resumed commercial trade.

On both sides of the Atlantic, businessmen competed for their share of this increasingly lucrative business. Faster ships made more money, even if it meant going full speed into bad weather and poor visibility. Many ships vanished, forever listed as overdue, and presumed lost to bad weather and icebergs.

On the Eastern side, the driving force was Samuel Cunard. In the 1840's he came to dominate the Atlantic market, with the line that to this day bears his name. The British government backed him financially, so the ships could, in the event of conflict, be requisitioned by the navy (which they often were).

On the Western side, a number of American lines tried, with varying degrees of success. The U.S. government was less inclined to become involved in these matters, and so capital was harder to raise for building ships.

As sail gave way to steam, this changed. The Americans were concerned that Cunard's steamers could be converted to warships. Faced with both real economic and feared military competition, the government began backing various companies to try and win trade back from Cunard.

The man to lead this was Edward Collins. With government subsidies he built 4 large steamships (Arctic, Pacific, Baltic, and Atlantic), bigger, faster, and more luxurious than Cunard's ships, to challenge his rival. The plan was to run a tight schedule across the Atlantic.

The Collins Line ships, with their combination of sails and paddle wheels, were some of the fastest in the world at the time. They showed the Atlantic could be crossed in the remarkable time of 10 days, and in a few cases, 9.

Backed by their respective governments, Collins' and Cunard's lines competed intensely to dominate the 3000 miles of north Atlantic. Until 12:15 p.m. on this day.

As the Arctic steamed west, through a heavy Newfoundland fog, she collided with a small French ship, the S.S. Vesta. The Vesta, although much smaller, had a hull reinforced with iron.

In the first few minutes after the collision, many of the Vesta's crew assumed their damage was fatal, and abandoned ship (against orders) to try and reach the larger Arctic. They were wrong. The crew of the Vesta worked miracles and overcame the damage.

Captain James Luce of the Arctic was a veteran of the sea. Believing his own damage to be minimal, he turned the Arctic around to aid the Vesta, and launched 2 lifeboats to help evacuate it's passengers to the Arctic.

These orders were quickly canceled when one of the lifeboats reported the severity of the damage to him. The ship was badly damaged. Like the Titanic 58 years later, he had the legally required number of lifeboats. And they weren't nearly enough to hold everyone on board.

Cape Race was 4 hours away. With his duty to his own ship clear, Luce abandoned the Vesta, heading for land. His hope was to beach the ship before she could sink.

The wreck of the Arctic over the next few hours quickly turned into a nightmarish struggle for survival, very different from the civility seen in the Titanic. Captain Luce accepted that he and his 11 year old son (who was traveling with him) were going to die, and did his best to save passengers. He was betrayed by his crew and most of his officers.

His crew disobeyed orders, commandeered the lifeboats, and fled. A trusted officer and handpicked team of seamen were placed in a lifeboat so that passengers could be lowered down to them. As soon as they reached the water they rowed away, with plenty of space in their boat.

Without lifeboats, Luce and his few remaining crew did their best. They tore the wooden deck to pieces, frantically trying to build rafts. Doors were torn from hinges to be used for flotation. All furniture made of wood was assembled on deck in hopes of saving more lives.

Of 408 who sailed, there were 86 survivors (64 crew, and 22 passengers). Not a single woman or child lived. They're remembered by a monument in Brooklyn's Green-Wood Cemetery.

Captain Luce, surprisingly, survived. He and his son went down with the ship, but were ejected from the vortex as it sank. As they swam away, a large wooden paddle wheel cover broke loose from below the sea. It launched into the air like a rocket, then came down, killing his son. And yet, at the same time, it became a makeshift lifeboat for Luce and a handful of swimmers. They were picked up after a few days by a passing ship.

The loss was a disaster, both personally and financially, for the Collins Line. Besides Luce's son, the deaths included Collins' wife and 2 of their children.

Although mostly forgotten today, the disaster dominated headlines on both sides of the Atlantic for a month, until replaced by the Crimean War. It had the same effect then as the Titanic would in 1912. Safety specialists recommended specific East-West shipping lanes. Slower speeds and loud whistles in fog. Lifeboats for everyone. The majority of the recommendations were ignored until the aftermath of the Titanic.

2 years later, in 1856, the Arctic's sister, the S.S. Pacific, vanished en route from Liverpool to New York.

It was another blow for the Collins line. There was an economic recession, and the U.S. government was now willing to let Cunard have the Atlantic. Collins' subsidies were cut, and in 1858 his line folded. The surviving ships were auctioned off.

The wreck of the Arctic hasn't been found (to my knowledge no one has looked).

The Pacific was thought to have been lost to storms or icebergs in the north Atlantic. To the surprise of everyone, she was accidentally found in 1991 in the Irish Sea, only 60 miles from where she left Liverpool. Why she sank remains a mystery.

Cunard survives to this day, though is now owned by Carnival Lines.

Government subsidies for shipping, with the ships to be used in time of war, continued into this century in all the major powers.

The last American attempt to share the Atlantic trade lies, mostly forgotten, in Philadelphia. She is the liner S.S. United States, built with subsidies after World War II. The government paid for her huge size and (even to this day) remarkable speed, with the plan of using her as a fast troop transport in future conflicts. Her commercial career, like all liners, was doomed by the passenger jet. Multiple attempts continue to be made today to save her from the scrapyard.

Sunday, September 26, 2010

Attention crooks!

Look, if you're trying to smuggle cocaine on an airplane, you take your chances. I think all of us have had our luggage lost at some point. So I suppose a bag with illegal drugs is as likely to go missing as one with my dirty laundry.

BUT, in the event that happens, you should probably take it as a loss. It is NOT going to help you to file a "lost luggage claim" on your case of contraband.

Like these guys.

I'd like to thank my reader Kayden for submitting this.

No means no

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

Mr. McPayne: "Yeah, are you covering for Dr. Cortex this weekend?"

Dr. Grumpy: "Yes."

Mr. McPayne: "Okay, I need more Vicodin for my pain."

Dr. Grumpy: "What kind of pain are you having, sir?"

Mr. McPayne: "You know, stuff that hurts. I need Vicodin for it. I get it from Dr. Cortex."

Dr. Grumpy: "Is this a new problem?"

Mr. McPayne: "Nope. If I can get some Vicodin I'll be fine."

Dr. Grumpy: "I can't call in narcotics for other doctor's patients on the weekend."

Mr. McPayne: "Why not? It sounds like your phone is working?"

Dr. Grumpy: "I don't know your case at all. You can call on Monday when Dr. Cortex will be back, or go to an ER if you feel this is urgent."

Mr. McPayne: "I ain't going to ER. I just want some Vicodin. Can I come to your office today so you can see me, and I can prove I have pain?"

Dr. Grumpy: "No, sir. My office is closed on Sundays."

Mr. McPayne: "Then can we meet at a McDonald's or something?"

Dr. Grumpy: "Goodbye." (click)

Sunday morning, 2:25 a.m.

"Hi! I'm a patient of yours and I'm 8 months pregnant and my water broke and I've started having regular contractions and I think I need to go to the hospital and can the doctor please call me back ASAP because OH SHIT! I THINK I CALLED THE WRONG DOCTOR PLEASE IGNORE THIS MESSAGE!"

(click)

Saturday, September 25, 2010

I still can't stand it.

This is a repeat of a post I ran last September. And since the same issue STILL drives me nuts, I'm putting it up again.


Dear Mr. President,

I don't want this to be a political blog. There are plenty of other sites for that. But we now face a national crisis of such serious proportions that it dwarfs other issues, such as global warming, health care, and middle-east peace. It now threatens the very fabric of our society, and directly affects every citizen. And I can remain silent no longer.

It's still September, and every store near me ALREADY HAS THEIR CHRISTMAS DECORATIONS UP!

I have nothing against the holidays, Mr. President. Peace on Earth and all that stuff. But moving them up as if they were being held in another time-zone or alternate universe is getting out-of-hand. As far as I know, Christmas hasn't budged in my lifetime. And treating every day like it was Christmas (like the stores seem to want me to do) is not helping.

The well-respected Nick documentary program, The Fairly Oddparents, has carefully researched what would happen if Christmas were held every day (Episode 107, air date 12-12-01 I have kids, OKAY!). Their conclusion? It would be catastrophic.

There also seems to be a degree of unintentional discrimination. For example, Hanukkah starts more than 3 weeks before Christmas this year, but I didn't see Hanukkah decorations going up 3 weeks before the Christmas ones. In fact, I haven't seen any at all yet. Or Kwanzaa stuff. Or Festivus. Or New Year's.

This seasonal perversion extends to other holidays, too. I mean, by January 2nd most stores are decked out with Easter junk, and on July 5th the Halloween crap is up.

So, Mr. President, I propose the following, federally mandated solutions (please note: I'm only including those holidays that retailers love. Let's face it, not many of us are out there buying gifts for Groundhog day or cards for Columbus day. I'm also leaving out local holidays like Delaware Statehood Day, the Montana Huckleberry Harvest Celebration, and the Byron, Illinois, Turkey Testicle Festival).

Valentine's Day Decorations will NOT be put up until the 3rd week of January.

St. Patrick's Day Decorations will NOT be put up until after March 1st.

Passover/Easter decorations will NOT be put up until after St. Patrick's day.

Independance day decorations (July 4th) will NOT be put up until the 3rd week of June.

Halloween stuff will NOT be put up before October 1st

Thanksgiving Stuff will NOT be put up before November 1st.

Christmas/New Year/Hanukkah/Kwanzaa/Festivus stuff will NOT be put up until the day after Thanksgiving.

(Please note: there should be some flexibility here, as Hanukkah and Easter/Passover may vary, but decorations should NOT be hung more then 3 weeks prior to holiday onset).


An alternative plan would be to have a single annual holiday combining all of the above, called St. Christmukahpasseastkwanpatfourthnewfestgivingween. Decorations for the combined holidays may be hung for 30 days prior to this event, and MUST be removed the day after.


Punishment for business owners who violate these laws would be on a 3-step basis:

1st offense: Business license revoked for one month.

2nd offense: Tarred, feathered, and forced to eat fruitcake.

3rd offense: Drawn and quartered, then served with fava beans and a nice chianti.


Yours truly,

Ibee Grumpy, M.D.

Friday, September 24, 2010

Tough case

I'm reading a hospital discharge summary, and discovered this quote from a neurosurgery resident:


"The patient was given Valium 10mg and Haldol 10mg. He then become lethargic, with decreasing oxygen saturations. The cause of his sudden lethargy was unclear. A head CT was unremarkable, and a STAT neurology consult was called."

Thursday, September 23, 2010

Doctors for Gooder English

Doing an online survey this afternoon, and encountered this question.


Gosh, I wonder what happened?

Yesterday afternoon I went to the hospital's EEG reading room to look at the day's studies.

Unfortunately, only one had gotten done all day, and there was a note on the monitor that said "Doctors, sorry we couldn't do all the studies today. We had to send the EEG machine to Bio-Med to have it thoroughly cleaned".

Lucky for me, it was one of my studies that did get done. It was on a confused ICU patient, so I started reading it.

The study ended abruptly at 8 minutes (normally they go for 20), with the following commentary in the tech notes:

0745: Pt yawning.
0748: Pt moving around, agitated.
0750: Pt pulled poop tube out of butt and is playing with it. Nurse running to bedside.
0751: Ending study.

Wednesday, September 22, 2010

Mary's Desk, September 22, 2010

(Lady comes in, signs in, then continues to stand at counter)

Mary: "Hi, Mrs. Patty. We'll get you back in a sec. Do you need something?"

Mrs. Patty: "Um, yeah, do you guys have a hamburger I can have?"

Mary: "Excuse me?"

Mrs. Patty: "Do you have a hamburger? I just dropped my mom off at the airport, and I'm really hungry."

There's a lot of that going around

For the original post on this topic, click here.


Dr. Grumpy: "Did you have an X-ray for the neck pain?"

Mrs. Daypro: "Yes. A friend said the carpal tunnel there is causing my neck problems."

Tuesday, September 21, 2010

Now THAT'S ambitious!

I'd like to thank my reader Miriam for submitting this. She noticed it in a hospital patient's (admitted for a knee problem) paperwork .

(click to enlarge)

And now for something completely different

Okay, people. Yours truly, Dr. Grumpy, has been asked to host (drum roll please) ONLINE GRAND ROUNDS next Tuesday. As many of you know, this is a weekly collection of blog posts of a certain theme.

Next week starts the 7th year of this, and they wanted someone talented, popular, and successful to host it. Unfortunately, that person wasn't available, and so they asked me instead. I've been assured that their decision to pick me was based on stringent criteria, such as having a pulse and a website. I tried to negotiate for a case of Diet Coke, without success.

So the topic for next week's Grand Rounds will be "Things that make me grumpy". I whine enough, so I'm opening up the floor to you guys. Please submit links to blog posts following this theme, but try to keep them (roughly) in some limits:

1. They should have at least SOME medical background to them. I don't want to hear about the guy who cut you off in traffic (unless it was a neurologist wired on Diet Coke), the crappy service you got at Denny's, or the high cost of flour.

2. Try to have some element of humor in it.

3. This is NOT a political blog, so I'm NOT going to put up rants from either side about health care, elections, or whatever.

How to submit: Please send your entries to pagingdrgrumpy [at] gmail [dot] com. Put "Grand Rounds" in the subject line, and include the URL of the post in the message, with a sentence or two about it. Sending huge amounts of money to my Paypal account is also recommended, but not necessary (nudge nudge wink wink).

The deadline will be Saturday, September 25, at 6:00 p.m. U.S. Eastern time. So submit early. Or else.

Monday, September 20, 2010

Urgent matters

Dr. Grumpy: "Have a seat. I'm Dr. Grumpy."

Mrs. Arowana: "Thank you. Pleased to meet you."

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

Mrs. Arowana: "Well, for the last 7 years I've had... Oh! I need to leave. I'm sorry!"

Dr. Grumpy: "Is something wrong?"

Mrs. Arowana: "I forgot to turn on the light in my fish tank after I cleaned it this morning!"

Dr. Grumpy: "But..."

Mrs. Arowana: "No, I have to go deal with this. The fish are my babies, and I don't want them to get angry at me."

(patient walks out)

Dear Ambien-CR,

Thank you for recently sending patient information packets to my office (I've already safely recycled them, don't worry).

I know your logo is a rooster. I still don't understand this, since the drug is supposed to make you fall asleep, NOT wake you up. But whatever.

Anyway, considering another term for rooster is "cock", and we all know what that's slang for, perhaps you should think of a better package design than this. Or maybe license the logo to Viagra, instead.

Because somehow I can just see this ending up in a novelty store next to a mistletoe belt buckle.


Sunday, September 19, 2010

Dead men tell no tales...



Yo ho, yo ho, a pirate's life for me!

We pillage, we plunder, we rifle, and loot,
Drink up, me hearties, yo ho.
We kidnap and ravage and don't give a hoot,
Drink up me hearties, yo ho.

Yo ho, yo ho, a pirate's life for me!

We extort, we pilfer, we filch, and we sack,
Drink up, me hearties, yo ho.
Maraud and embezzle, and even hijack,
Drink up, me hearties, yo ho.

Yo ho, yo ho, a pirate's life for me!

We kindle and char, inflame and ignite,
Drink up, me hearties, yo ho.
We burn up the city, we're really a fright,
Drink up, me hearties, yo ho.

We're rascals, scoundrels, villains, and knaves,
Drink up, me hearties, yo ho.
We're devils and black sheep, really bad eggs,
Drink up, me hearties, yo ho.

Yo ho, yo ho, a pirate's life for me!

We're beggars and blighters, ne'er-do-well cads,
Drink up, me hearties, yo ho.
Aye, but we're loved by our mommies and dads,
Drink up, me hearties, yo ho

Yo ho, yo ho, a pirate's life for me!

Aaargh! Happy Talk Like a Pirate day, mateys!

Saturday, September 18, 2010

Rolling on the River




It was the American Civil War.

In February, 1862, the city of Nashville, Tennessee, was captured by Union forces. This began one of the strangest episodes in North American military history.

Overnight Nashville was converted into a supply depot for the Union's southward moving forces. The amount of locomotive and riverboat traffic increased dramatically, as did the population of Union soldiers. Some were stationed there, others were passing through on their way to different fronts.

And prostitutes, the eternal ancillary business to military campaigns, became prevalent. An area of town called Smokey Row (named after the opium dens) featured over 70 brothels. Aside from thousands of soldiers, rumored clientele included Lincoln's future assassin John Wilkes Booth, and Lincoln's successor to the Presidency, Andrew Johnson (no link aside from coincidence has ever been uncovered).

Syphilis and gonorrhea were rampant. Soldiers and prostitutes equally became ill from diseases spread in Smokey Row.

Pvt. Franklin Bailey wrote his mother that he'd need a dictionary "to find words enough, and then I could not find them bad enough, to express my hatred of those beings calling themselves women" in Smokey Row. Later in the same letter, however, he tried his best (perhaps he borrowed a thesaurus) and wrote that they were "abominable, low, vile, mean, lewd, wanton, dissolute, licentious, vicious, immoral, and wicked."

Pvt. Bailey, however, was an exception. The general feeling of most troops was that "No man can be a soldier unless he has gone through Smokey Row"

The Union commanders were less concerned with morals than they were with military capabilities. With many of their troops hospitalized from sexually transmitted diseases, the ability to launch further military campaigns was impaired.

Punishing soldiers didn't help. Nor did medical lectures. And antibiotics were in their infancy.

Something had to be done. Since the soldiers were needed to fight the war, they couldn't leave.

And so, on July 6, 1863, General James Morgan issued "Special Order No. 29".

This order basically said that prostitutes in Nashville were to be rounded up and sent somewhere else. How and where weren't specified.

And so into the picture entered a plain 3-month-old steamboat named Idahoe and her captain/owner, John Newcomb.

Idahoe was one of many steamboats at the waterfront under charter to the army. History has not recorded why she was chosen out of the many available.

Union forces rounded up hundreds of women from Smokey Row, storming buildings and catching women who tried to jump out of windows to escape. Non-prostitutes were also inadvertently nabbed in the confusion, just from being too close to that part of town during the operation, and required family to free them.

On the morning of July 8, Capt. Newcomb was finishing his breakfast coffee on board the Idahoe, when he was assaulted by noise. As he walked to the gangplank he was met by Colonel George Spalding, who handed him an order that read, "You are hereby directed to Louisville, Kentucky with 100 passengers put on board your steamer today, allowing none to leave your boat before reaching Louisville."

Even as Newcomb read this, the ladies were being driven on board. He was given no money to buy food for them, nor guards to enforce discipline.

How many women were put on board the Idahoe is unknown. The ship was built for 100 passengers. No reliable count was taken, and the best estimate is 150-200.

The journey to Louisville was a nightmare for Newcomb. His unwanted passengers destroyed the boat's once luxurious furnishings. He had to buy ice (for fevers) and food, at his own expense. Places where he stopped for supplies put guards at the dock to keep the women from disembarking.

The prostitutes continued to ply their trade, waving at men as they went upriver, and raising their dresses to advertise. Customers rowed themselves on board for brief stays as the Idahoe chugged slowly along.

By the time he got to Louisville on July 14, word of his unusual cargo had preceded him, and local authorities refused to allow him to disembark the ladies. Instead, he was ordered to proceed to Cincinnati. Kentucky's military governor assigned several soldiers to the Idahoe to serve as guards to help enforce discipline. This quickly failed, as the men given this coveted assignment received free services from the passengers.

By the time he got to Cincinnati, of course, the local government also refused to let him unload his passengers. Newport, Kentucky, on the other side of the river, didn't want the "frail sisterhood" (as the local newspaper called them), either.

So with nowhere to go, the Idahoe anchored off Cincinnati for several days, and turned a brisk business as a floating brothel while Captain Newcomb aged rapidly. Somehow he managed to persuade the army to telegraph Washington D.C. for a decision, and the question went all the way to U.S. Secretary of War (now called Secretary of Defense) Edwin Stanton.

Stanton was managing the complex issues of a war covering half a continent and an ocean, and was likely stunned by the unusual decision that showed up on his desk that day. He came up with a direct solution: Take them back to Nashville, and deal with it.

So on August 3rd the Idahoe returned to Nashville, and it's passengers resumed their usual lifestyle. This gave the headache back to the Union commander (now General Robert Granger) who spent a few days trying to find a solution, and finally came to a very pragmatic one: he legalized prostitution.

Under the new rules, each "public woman" had to have a license ($5) but needed to pass a medical examination first. She was then required to have another exam every 10 days in order to keep her license.

The solution was a success. Suddenly the "wayward women" had a legal profession. Disease control (by the standards of the time) improved. The prostitutes now had access to medical care that they didn't have previously. The Union doctors assigned to the "Hospital for the Reception of Valetudinarian Females from the Unhealthy Purlieus of Smokey" (yes, that really is what they called it) began taking notes, and wrote some of the first detailed reports on the sociology of prostitution.

The program was such a success that physicians from other cities came to study it.

Captain Newcomb spent the next 2 years trying to get reimbursed, meeting with military officials and eventually pleading his case in Washington. Finally, on October 19, 1865, he received payment of $5316.04. This was the amount he'd been asking for from the beginning for damages, new furniture, fuel, food and medicines purchased, etc.

He had a long career on the river, but never shook off the reputation as the "captain of the floating whorehouse".

He sold the Idahoe a few years later. In 1869 she was lost in the Washita River, cause unknown.

Friday, September 17, 2010

Skool Nerse Time

This is Mrs. Grumpy. Yes, another exciting school year has begun, and I'd like to share a short play with you.


Kid walks into my office today, doing some sort of weird I-can't-hold-still dance move.

Nurse Grumpy: "What's up?"

Little kid: "My butt itches!"

Nurse Grumpy: "Have you tried scratching it?"

Kid scratches ass for 10 seconds.

Little kid: "Thanks nurse, that feels much better." (leaves my office)

Thursday evening, 6:18 p.m.

Dr. Grumpy: "This is Dr. Grumpy. You called earlier?"

Mr. Husband: "Hi, doc. Hey, sorry my wife couldn't come to her appointment today. She's had such a bad migraine it's unbelievable. She's been so dizzy with it she can't drive or ride in a car. She can't even get out of bed."

Dr. Grumpy: "I'm sorry. Has it gotten any better this afternoon?"

Mr. Husband: "No, if anything it's worse. She's barely able to move."

Dr. Grumpy: "Can I talk to her?"

Mr. Husband: "Not right now. She's out in the yard climbing a tree, trying to get the cat down. Can she call you back when she's done?"

Thursday, September 16, 2010

Anatomy 101

Yesterday I saw a guy who repeatedly mentioned that he's a nurse.

When he called he said he was having "carpal tunnel problems". That's fine, I can handle that.

But when he came in, all he wanted to talk about was his neck pain.

I can handle that, too. But I asked him why he'd said he was having carpal tunnel problems when he called.

He said "because the carpal tunnel is in the neck".

When I tried to correct him, he argued with me, then walked out. Said he was going to "find a doctor who knows his damn anatomy."

Wednesday, September 15, 2010

Who lives in a pineapple under the sea?

I'd like to thank my reader Linda for submitting this.

There are some things you never want to be stuck with.

Like finding out that you've been a habitat for SpongeBob Squarepants.

Or worse, that you're the one who left him there.

E-prescribing idiocy

I bitch about it. The Angry Pharmacist bitches about it. This is nothing new.


But yesterday afternoon I discovered a whole new reason to hate e-prescribing.


I have a lady who takes Fukitol 3mg, four times a day.

Fukitol only comes in 1mg pills. So she takes 3 pills, four times a day.

So 12 pills each day. OR 360 pills in 30 days.

HOWEVER, her insurance requires her to use Lostinthe Mail-Order pharmacy.

Like most mail-order pharmacies, this one only sends out 90 day pill supplies at a time.

So Mrs. Patient asked me to send it by e-script to Lostinthe Mail pharmacy.

12 pills x 90 days is 1080 pills. So I just transmit a script for 1080 pills.

Sounds easy, huh?

The online thing rejected the script, on the grounds that it won't allow pill supplies of more than 999 pills at a time.

I tried submitting it for 2 scripts of 540 pills each. It wouldn't allow 2 scripts of the exact same thing.

So I submitted it for 999 pills for 90 days, and figured Annie would just tell the patient the reason for this, and we could make up the difference with samples.

Of course, the online e-script program rejected this, too, and pointed out that a 90 supply for the patient is 1080 pills. It even asked me to resubmit it for that amount.

Which I did. And it was promptly rejected for being > 999 pills.

Catch-22.

I mailed a written script for 1080 pills to the patient and told her to send it to them. And scream.

Tuesday, September 14, 2010

Let's hope you aren't

Dr. Grumpy: "Does the hand pain wake you from sleeping?"

Mr. Carpal: "Sometimes."

Dr. Grumpy: "Does it bother you when you're driving?"

Mr. Carpal: "Why would I be driving while I'm sleeping?"

The joys of search engines

A doctor in my area died last week. Dr. Pissy and I were wondering what happened, so I typed his name into a search engine.

These were the first 3 links that came up:

1. Read the obituary for Dr. Unusualname.

2. Sign the online memorial book for Dr. Unusualname.

3. Make an appointment to see Dr. Unusualname.

Monday, September 13, 2010

Afternoon patient at Dr. Grumpy's

Mrs. Cuticle: "Harold! Stop chewing your fingernails! We're at the doctors!"

Mr. Cuticle: "Shut up! I'm hungry!"
 
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