Patient quote of the day

"The pain went down through my legs. Not all my legs, I mean, but just the ones on the bottom of my body."

Sunday night, 11:17 p.m.

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

Mrs. Franklin: "Hi, you see me for nerve damage in my foot, and I'm on Neurontin."

Dr. Grumpy: "Yes. What's up?"

Mrs. Franklin: "Well, lightning struck my apartment complex an hour ago, and started a small fire in the laundry room. The fire department put it out, and everything is okay now."

Dr. Grumpy: "Are you okay? Was your medication lost?"

Mrs. Franklin: "Oh, everything is fine."

Dr. Grumpy: "Why are you calling?"

Mrs. Franklin: "I just figured this is the sort of thing my doctors should know."

Truth, NOT yak shit

The battle against cancer was set back recently, when politicians (not physicians) running for office decided that fear beats hope. False claims were made that the HPV vaccine (which has the potential to cure cervical cancer by preventing it from ever starting) causes mental retardation.

I'd therefore like to post this statement by the president of the American Academy of Pediatrics, Dr. O. Marion Burton. He is not a politician, but is an expert in the care of children.

I hope his statements carry more weight than those of politicians who are more interested in sound bites than truth.

"The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation.

There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.

The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That’s because this is the age at which the vaccine produces the best immune response in the body, and because it’s important to protect girls well before the onset of sexual activity.

In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer."

That's 4000 young women dying each year from an easily preventable disease. One of them could be your daughter - or mine. Marie will get the vaccine next year.

I did not receive any money or gifts to make this statement, nor do I own a financial interest in companies that make these vaccines. I don't know Dr. Burton, either. I'm posting this because, as a yak herder, I know manure when I see it, and believe it should be cleaned up.

Memories...

Like most residents, I moonlighted in various ER's and urgent cares around town.

One night I saw a guy in SERIOUS pain.

He was at Local Grocery, buying a can of soup.

When the pretty teenage girl cashier asked "Anything else you need?" He said "How about this, sweetie?" whipped his winkie out, and laid it on the checkout counter.

The cashier grabbed the soup can and smashed him flat.

The urologist I paged was laughing so hard that he had to hang up and call me back when he'd stopped.

I'll take your word on this one

Mrs. Epistaxis: "Sorry I'm a few minutes late. My mom had a bad nosebleed, and I had to drop her off at the ER."

Dr. Grumpy: "I hope she'll be okay."

Mrs. Epistaxis: "It was a mess. Here's a picture." (whips out iPhone with gory picture).

Dr. Grumpy: "That's okay, I believe you. How have you been?"

Mrs. Epistaxis: "I also have the kitchen towel she was using in my purse here..." (starts digging in purse)

The cup

It's just a coffee cup on our break room shelf.

Coffee cups collect at medical offices, until you have cabinets full of them, far out of proportion to the number of people who work there. Staff bring them in, then forget them. Old employees leave them when they move on. Drug companies used to drop them off.

So as time goes by, coffee cups multiply. After a while the less-used ones get migrated to the top shelf.

This cup sits on the top shelf, at the front. I put it there.

It was brought in by a patient. Not as a gift. He just preferred drinking coffee out of mugs, and didn't like paper cups or plastic/metal containers. So he carried around his own mug, would buy coffee and mix it up in paper cups, then pour it in his mug when he got to his office. Or, in this case, my office. Any place with a stable surface.

I saw him only once, for something minor. He was in his late-30's, married, 2 kids, a business professional. Nice guy. He explained his coffee issue to me as he set his mug on my desk. I thought it was funny, but hell, we all have our own neurosis. We talked about his leg pain, worked out a treatment plan, and agreed to meet back in a month.

The day after he left I found his coffee cup in the exam room. He'd left it behind in a hurry to get out and make it to a meeting on time. I washed it and set it on the top shelf, to give back at his follow-up.

3 weeks later I came in one morning and began leafing through the overnight faxes. One was from the state coroner's office, requesting records. Mr. Cup had died that night of a massive heart attack.

It's been 2 years. When I'm having a bad day, I go look at the cup.

How much do you know about Mom?

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

Mrs. Noclue: "My Mom died of cancer. I think it was prostate cancer."

Death by Magnet

Dear MRI facility,

My reader Jeanette was kind enough to send me the pamphlet you left at her office, showing the advantages of your new, non-claustrophobic, no-tube MRI machine.




I did a highly unscientific poll of claustrophobic patients since then, and all agreed that they'd rather get Valium and do a regular MRI than your "simulated lynching" technique.

But, since I often occasionally sit here and think about strangling my patients, I'll be sure to keep you in mind.

They drive me crazy

Mr. Ophth: "Since the fall I've had trouble seeing. Everything is blurry and out of focus."

Dr. Grumpy: "Did you hit your head?"

Mr. Ophth: "No, but I broke my glasses."

Annie's desk, September 12, 2011

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

Mrs. Clostridium: "Yeah, I was wondering if my Botox for migraines got approved yet."

Annie: "Hang on... No, your insurance denied it. You only have 2 migraine days per month, and it's only covered for patients who have 15 or more migraine days per month."

Mrs. Clostridium: "But I really want Botox. Can he give me something that will make me have more migraines?"

Sunday rounds

I got dragged in to the hospital yesterday for a consult.


Dr. Grumpy: "When did this start?"

Mrs. Stroke: "On Wednesday. I was doing some errands, and suddenly noticed I was dragging my right leg."

Dr. Grumpy: "Why did you wait until today to come to the hospital?"

Mrs. Stroke: "My daughter-in-law's baby shower was yesterday. They don't set themselves up, you know."

Medical news

Since I had to spend yesterday outside at a park, I dragged a pile of dusty old journals with me to do some reading. And I learned that:


Patients who have migraines with nausea are more miserable than patients who have migraines without nausea (though neither group liked having them).

Pain Medicine News, August 2011

The best predictor for improvement in a chronic migraine patient is that they have fewer migraines.

Neurology, February, 2011.



Cancer patients with frequent pain have a lower quality of life than cancer patients with no pain.

Pain Medicine News, April, 2010



People on higher doses of narcotics are more likely to accidentally overdose than people on low-dose narcotics.

Pain Medicine News, April, 2010

Weekend video

Due to a bunch of Boy Scout crud today, I'm just going to post the horrifying "People of Walmart" music video.

In a bizarre twist, I've noticed that after watching it once or twice my brain starts to fill in the words to Billy Joel's "We Didn't Start the Fire", though the People of Walmart music continues.

Patient quote of the day

"I want to find a new GI doctor. I can never get in to see my current one. The only face time I ever had with her was during my colonoscopy."

Spirochetes: Bringing joy wherever they go

This showed up on my fax machine last night:





Because, you know, people always look that happy when told they should be tested for syphilis.

Weenie barbecue

In spite of my daily attempts to keep patients sane (at the expense of myself, Annie, and Mary) bizarre news continues to happen.

Thank you, Katy!

Define "fatal"

Mr. Reaper: "Sorry I had to cancel last month. My mom had a fatal heart attack."

Dr. Grumpy: "I'm sorry."

Mr. Reaper: "It's okay. She's better now, and just started cardiac rehab."

Love and marriage

Dr. Grumpy: "Anything else going on?"

Mr. Discord: "My wife and I are having a lot of conflict. I have these health problems, and she's more concerned with other junk than she is with me."

Lady Discord: "That's not true! I always put you first."

Mr. Discord: "So we're going to counseling..."

(Lady Discord whips out iPhone, starts texting)

Mr. Discord: "What are you doing?"

Lady Discord: "Updating my Facebook status, so my friends know we're at the doctor."

Tonight's forecast: Cold. And not getting any warmer.

As I've said before, this blog is mostly about the insanity of medical practice.

But sometimes things are too weird not to share...

Some of you have written asking way I only post links, rather than the stories themselves. I do this to avoid any sort of copyright issues.

Cartoon characters gone bad

When robbing a convenience store you should wear a disguise.

Some disguises are better than others.

Thank you, LJ!

Unwanted attention

A doctor in my building is retiring, and selling off his practice's stuff.

So yesterday morning he put signs all over the building saying "OFFICE CLOSING! EVERYTHING MUST GO! FURNITURE! OFFICE SUPPLIES! COMPUTER! MEDICAL EQUIPMENT" with his phone number and suite in surprisingly small print at the bottom.

And, on my floor, he put the flier right outside my office.

So all day long Pissy and I's staff were inundated by people coming in to see what we're selling, making us offers on the lobby chairs, asking our staff if they needed new jobs, etc.

And, of course, the way rumors spread I've gotten several calls from other docs who've heard I'm closing up. And panicked patients who are afraid they'll have to find a new neurologist.

One hot set of wheels

There are many alternatives to a car for transportation.

This is not of them.

Thank you, JLG!

Must be a really old model

Patient quote of the day:

Mr. Moore: "I just got a new computer. It has a 1 trilobite hard drive."

Labor Day Holiday, 4:37 p.m.

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

Mr. McGuire: "Yeah, I'm all out of my medicine, and need it called in."

Dr. Grumpy: "Okay, I can do that. What pharmacy do you want it called to?"

Mr. McGuire "Well, I normally use TAP Pharmacy, but they're closed for the holiday."

Dr. Grumpy: "There's a 24 hour Pills-R-Us I can call it to."

Mr.McGuire : "Yeah, but my insurance won't cover me there. Can you call the people at TAP Pharmacy and make them come in and open for me?"

Random pictures

Today is a holiday here in the states (our equivalent of May Day). I understand many countries have parades on May Day. In America we traditionally watch sporting events on television and grill/eat large amounts of beef.

Anyway, since I'm busy fixing the barbecue so Mrs. Grumpy can cook a yak, I'm just putting up pictures my readers have sent.

(click on images to enlarge)


First, a reader in Arizona found this headline in her local online paper. Apparently the Mesa School District is trying to find new teachers. And with good reason:




Next, we have this delicious looking snack for neurologists and zombies:







To prove that the "City of Brotherly Love" is still alive and well, a reader from Philadelphia sent in a note he found on his windshield:






And, finally, for those new parents out there trying to save money, Amazon is selling used diapers:

Sunday reruns

People use different phrases to mean the same thing. Case in point: migraines.

Some patients say "I have migraines". Others say "I get migraines". Occasionally one will use the odd phrase (at least to me) "I take migraines" to mean the same thing (I always want to ask who they're taking them from).

But today I had a lady who used a more, uh interesting, phrase.

When she gets a migraine she has to go lie down in a dark room (which is common). So, for whatever reason, she uses this act to refer to the migraine.

In other words: when she gets a migraine, she calls it "going down".

It is remarkably hard to keep a straight face when the young lady across from me says things like:

"I went down 3 times last week."

"July was awful. I spent the entire month going down".

"I went down on Saturday. I had to do it in front of my kids, too."

And, as she was leaving, she said, "I feel another one coming on. I just know I'll be going down tonight, but have to wait until my husband gets home."

Memories...

In 1997 I was in Boston for a neurology meeting.

One morning I was walking from my hotel to the meeting, and stopped at a Starbucks on the way. After getting my order I sat down by the window to glance through a newspaper.

Suddenly an ambulance, sirens and lights on, came flying down the street outside at warp speed.

It screeeeeched to a stop in the middle of the street. 2 guys got out of the front, walked into the Starbucks, and waited patiently in line. They left the ambulance running in the middle of the street (blocking traffic) with the sirens and lights on.

When they got up to the counter, one used his radio and called the guy in the back with the patient to see what he wanted them to get him.

They got their order, walked back out, squealed the tires, and drove away at warp speed.

I was the only one there who seemed at all surprised.

Mary, bring me a strong drink

Mr. Pill: "I didn't take it. The lady at the drugstore told me it had all kinds of side effects, and that I shouldn't even try it."

Dr. Grumpy: "The pharmacist said that?"

Mr. Pill: "No. It was a lady behind me in the check-out line. She was buying cigarettes."

Wild times

In the past I published an article about a guy who was dating a carwash vacuum cleaner.

And who can forget the touching romance between a man and his patio table?

This week we had a guy elope with a plastic pool raft.

Part of the problem may be that people just seem to keep losing their undies.

This sad problem of keeping your pants on is even affecting the mayor.

Don't we all

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

Mr. Son: "Yeah, both my parents lived until they died."

Definitely not my field

Dr. Grumpy: "Do you have a copy of your most recent labs?"

Mrs. Whiskers: "Yes, here they are" (pulls papers out of purse, hands them to me).

Her lab values were all abnormal, but the normal ranges listed weren't what I'm used to, either. None of them made sense. I was trying to figure this out when I noticed the patient information in the upper corner:

Name: Sparkles
Age: 5 Y, 3 M
Species: Feline

Dr. Grumpy: "Um, I think these are your cat's labs."

Mrs. Whiskers: "Oh, hang on. I have mine here, somewhere..." (starts digging in purse).

Today's tip

If 2 shady-looking characters offer to sell you an iPad at a great price, in a McD's parking lot, it may not be a good deal.

Thank you, Don!

Attention patients!

I'm sorry that you landed in the hospital, or that your nurse there isn't as responsive to your call light as you feel she should be. I'm sure she has several other patients, and is doing her best.

BUT

Mary and Annie are NOT your nurses. Just because your nurse is busy doesn't mean you should call my office to see if they can drive over to bring you pain medicine, have someone come fix your TV's volume, or get you coffee or a warm blanket.

So stop calling my damn office.

Thank you.

In the news

Two unrelated articles:

1. Sometimes being drunk and naked isn't enough. Then you need a raccoon.

Thank you, Tanya!

2. Now THIS is what I call a gardening accident.

Thank you, Webhill!

Dear Dr. Whozawhatsit,

Thank you for faxing me this remarkably helpful picture last night:





For the life of me, I have no idea what it is. Since you left the name off, I have no idea who it is, either. In fact the only thing legible on it was your name. So maybe it's you? But you're not one of my patients (perhaps you should be).

Anyway, I'm sure these amazingly clear pictures will be of tremendous use in my treatment of their condition, whatever it is. Whoever it is. And whatever the hell it's a picture of.

Yours truly,

Ibee Grumpy, M.D.

Mary's desk, August 29, 2011

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

Mrs. Krayzd: "Hi! I need to reschedule my appointment with Dr. Grumpy. There's no way I'll be able to make it that day."

Mary: "Okay, when is your appointment?"

Mrs. Krayzd: "I have no idea. Can you look it up for me?"

First day of school

Today the Grumpy kids (and Carson, whoever he is) are back to school.

It's also come to my attention that classes are starting today at the medical school I attended.

In honor of that, I'd like to show this brief educational video to let the new medical students know what the next 7-10 years of school and residency will be like.

Maybe she can get a job at Dunkin Donuts now...

Yes, yet another fast-food entrepreneur goes down.

Thank you, Janine!

Sunday morning, 1:38 a.m.

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

Mr. Beer: "Hi ya, Doc, how ya doin'?"

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

Mr. Beer: "How's Las Vegas? I LOVE Las Vegas."

Dr. Grumpy: "It was fine. Why are you calling?"

Mr. Beer: "Mary had said you were going to be in Vegas, so I thought I'd give you some pointers. I have a great Blackjack system, and there's an awesome bar over at..."

Dr. Grumpy: "I'm home. If you don't have a medical reason to be calling, then I'm getting off the phone."

Mr. Beer: "Hang on, why don't you get something to write on, in case you go back, and..."

Dr. Grumpy: "Good night."

Great sign placement

Let's face it, if you need a nebulizer breathing treatment while using this thing, it may not be safe to use it at all.


(click to enlarge)





Thank you, Boris!

Friday afternoon whatever

Mr. Bacov: "I have anorexia, where I read stuff backwards."

Dr. Grumpy: "You mean dyslexia."

Mr. Bacov: "Whatever."

Thursday afternoon: 3:49 p.m.

We were busy yesterday, catching up on mail, returning phone calls, and loading backpacks for school next week.

The phone rings:

Dr. Grumpy: "Hello?"

Mr. Kramden: "Hi, I'm the short bus driver for Wingnut elementary school. I just want to verify that I'll be dropping Frank Grumpy off at your home each day?"

Dr. Grumpy: "Yes."

Mr. Kramden: "Okay, and Carson, too?"

Dr. Grumpy: "Um, who's Carson?"

Mr. Kramden: "He's your other kid."

Dr. Grumpy: "We don't have a Carson. Our other kids are Craig and Marie, and they go to the Afternoon Program at Grumpyville Center."

Mr. Kramden: "Well, my list says you have Carson, and I'm dropping him off at your house."

Dr. Grumpy: "I told you, we don't have a kid named Carson. There isn't any kid by that name in this neighborhood. I don't even know a kid named Carson."

Mr. Kramden: "Look. Who has the list here? You or me?"

Great moments in refrigerators

"What could possibly go wrong?"

No matter where you go, there you are

And so, after a day of flying, a delayed take-off, my kid barfing on a plane, messed up hair, returning our rental van, and one lost luggage item, we are now back home. Items that made it successfully home included Craig's hair and the humungous cloth basketball.

I'll be spending today catching up on junk at the office, and will likely return to my regularly scheduled whining on Friday.

School starts again on Monday. This year we ordered our supplies pre-packed, but I'm re-running my back-to-school shopping guide for your entertainment. Until I get caught up on my groove.


Dr. Grumpy's Guide to Life: Shopping for school supplies

Okay, so this is the 2nd edition of my helpful newsletter (If you missed the 1st one on surviving your child's birthday party, click here).

Today's issue will focus on what I discovered to be a horribly traumatic life-altering experience: Back-to-School week at OfficeStaplesMaxDepot. There's one right across the street from my office, so I go there regularly for supplies. It's quiet, the employees are generally helpful, and I know my way around it pretty well.

I naively thought this would be easy.

So on to the lesson:

1. Do NOT volunteer for this job (flip a coin, or arm wrestle, or have a duel to decide instead).

Silly me. When Mrs. Grumpy was wondering when she'd have time to get the school supplies, I volunteered. I figured "How hard can it be? Hell, it's just some pencils and a bottle of glue". DUMBASS!!! The list is HUGE, and features items from the mundane (No. 2 pencils), to the specific (Expo dry erase markers, wide tip, in blue, green, yellow, and black) to the odd (1 Pringles can with lid, original flavor, empty). It took me 2 freakin' hours!

2. Be prepared. Normally there are 5-10 other quiet business-type people in there. NOT THIS WEEK! Holy Crap! An African street bazaar is an orderly affair compared to this! Deranged parents running on caffeine! Kids running amok! Store clerks running for their lives! And all the crazed parents are trying to read off a list, push a cart, yell at kids, text, and scream into a cell phone at the same time. Bring a water bottle, food, a map, a cattle prod, and a flashlight. A card with your blood type, hospital preference, and next of kin is also a good idea.

3. Do not leave your cart unattended. People will steal your shit out of it. I AM NOT MAKING THIS UP! I had my cart 2/3 full with the crap on my list, when I left it at the end of an aisle to go find notebooks (spiral, wide-ruled, 100 pages each, single subject, 1 red, 1 blue, 1 green). When I returned 3 minutes later about half the stuff I'd already put in it was GONE! I watched a few minutes later as it happened to others. Apparently, when you walk away from your cart, people think it means they can raid it for supplies they haven't had a chance to pick up yet. "Hey, this guy has those index cards (2 sizes, lined and unlined, 100 each) that my kid needs. Cool. I'll scratch that off my list".

If another parent asks you what school your kid goes to, or who their teacher is, DO NOT ANSWER. Ignore them. Pretend you're deaf, or that you don't speak English. They are not making conversation. They are casing your cart, and if they find out your kid is in the same class as their kid, they'll wait until you aren't looking to take your stuff (or just switch carts).

Best part was when I went to ask an employee for help finding something (Flair Correction Pens, in 4 colors). When I got back to my cart the box of 12 ultra-fine tip Sharpies I left in it had been opened, and someone had taken one of them. They'd even doodled on the shopping list I left in my cart to make sure they were taking a pen that worked.

Oddly, you can leave valuables in your cart. Your wallet, purse, and gold jewelry will be perfectly safe if left unattended, but the $2.69 box of high-lighters (12 markers, large tip, in 3 colors) will vanish.

My recommendation: bring a child to guard your cart, preferably one with an iron bladder and who's old enough to use a Taser or firearm if needed. If your kids don't meet this requirement, stop by Home Depot and hire one of the day laborers who hangs out in front looking for work.

4. Do not look for certain numbers of things. The people who make these lists have no idea how things are sold, so it lists things as "1 Expo dry erase marker, chisel-tip, red). Great. They don't sell red ones individually, just in boxes of 4. Or the Flair Correction Pens don't come in only 4 colors, but they do come in 8. Just buy it. If you aren't certain what item the teacher wants, just buy everything in sight and return the rejects later.

Alternatively, if the teacher only wants 1 of an item, such as, say, an ultra-fine tip Sharpie (which only come in boxes of 12), you can always look for an unattended cart with a box of them in it, and take one. If paper is handy, try doodling on it to make sure you are stealing one that works.

5. Hold your place in the check-out line AT ALL COSTS. Reserve it as soon as you walk in the store BEFORE shopping. Use a child (preferably your own) if possible. Other options include day laborers from Home Depot, mannequins, dogs, and aggressive Venus Fly Traps.

6. When in doubt, ask the bleary-eyed, terrified employees for help. If nothing else, it's fun to watch them try to convince you that they don't speak English as they run outside for a cigarette.

Good luck!

Crime in America

Is nothing sacred?

Thank you, WebHill!

Summer Vacation, Day 10

Our room has the most idiotic feature on Earth (no, not Magic Fingers). The air conditioning unit blows straight up into the curtains, launching them away from the window. So you have a choice between being comfortable at night or having your room randomly inundated by the bright lights of the Strip as the curtains flop in the breeze. With the fan set on high it could cause a seizure.


The room also includes a copy of this generic local promotional magazine:

(click to enlarge)





Take a good look at the cover, and notice how none of the people watching the clown look even remotely entertained. In fact, the person immediately behind and to the right of Bozo is falling asleep. Now, maybe this is because the only seats they could get were facing the clown’s ass, but you’d think the photographer could try for more enthusiasm.

On a random note, I forgot to write about one of the kids' favorite things at LegoLand: The Fire Academy. This 2 minute torture session race is one of the most grueling experiences in the park: 4 families compete against each other to: pump (by means of a handcart) a firetruck down a road to a "fire", use a fire hydrant and 2 water hoses to put it out, then pump the truck back. The fire truck and hoses each take 3 people to operate, and you can have up to 4 people on a team. So this builds serious teamwork. You don't win anything except pride (not even a few measly Lego bricks). And, I'm pleased to say, the Grumpy family over the course of the day finished 3 and 1.


Today we walked around Las Vegas.

Going through the shopping areas is always interesting. In the Flamingo’s lobby they have a sex shop, featuring a doorway made to look like a very tall lady’s legs:






And inside the mannequins (love the adult diaper) are about to get it on:






A store over at Caesar's Palace is debuting the latest in womens’ fashion, which apparently involves wearing a large purse on your head.






This afternoon the kids wanted to hit the pool again. After passing several people trying to sell us timeshares (I’m in a fucking bathing suit, and DO NOT want to stop and talk to you here in the middle of the damn lobby) we got there.

The Excalibur has a bizarre layout where people in tower 1 have to walk through THE WHOLE DAMN CASINO to get to the pool. Tower 2 is right there. Why they don’t have an entrance at each end of the building (when the pool obviously connects to both sides) is beyond me. Because I’d think that seeing yours truly go by wearing nothing more than a bathing suit and flip-flops would scare people away from the slot machines.

We got down to the pools, and were reassured by a look at the lifeguards: there were 5 of them at the one the kids went to: One was busy texting, another was filing her nails, and a third was wearing, I swear, knee-high socks and high-top basketball sneakers. This is not something you normally see in an occupation that requires you to quickly jump in the water at random intervals.

After reassuring Craig that his hair looked fine, I went into the pool myself. There was a row of teenyboppers sitting at the front, cleverly stationed there by plastic surgeons to show off the coming 2012 line of breast implants. Across from them, as a public service announcement to use sunscreen, was a lady who looked like a bizarre cross between a Barbie doll, Charles Atlas, and a leather purse. After one look at her I wanted to buy out the Coolibar catalog.

The only real winner we had in Las Vegas was Marie, who over the course of 3 days found $9.80 in change at the bottom of the Excalibur’s pools.

As we walked back through the lobby, dripping wet, in swimsuits, some time-share guy blocked our path to ask “Hey! Have you guys been at the pool?” ("No, you moron, it was raining over by the buffet"). I don’t know what look it was that I gave him, but he backed off fast.


Tonight we went down to the medieval-themed arcade. When I was a kid the games were 25 cents each. Now they’re $2.

These places are always frightening to me because Marie is the MASTER of crane games (“be the crane, Squidward”). So we knew we’d be leaving with a few small stuffed animals. But we weren’t prepared to see her show up with this giant basketball (Diet Coke can placed for comparison) that she won.





Mrs. Grumpy and I exchanged the “How the hell are we going to get that on the plane?” look, so common to parents in these situations.

After a strenuous time playing arcade games, the tribe apparently thought we were on a cruise, and wanted to go for pizza, grilled cheese, and ice cream. So we went to the coffee shop, where Marie argued with the waiter that she also wanted bacon, even though it wasn't breakfast. And some chocolate chip cookies. She gave him some soggy coins from the pool as a tip.

And so, from somewhere in the Excalibur hotel, happy Summer Vacation to all, and to all a good night.

Summer Vacation, Day 9

Being trapped in the hotel room in the morning is a torture session. Why? Because the only kids’ channel is Nick Jr., which is far below my gang’s ages. So we watch such moronic fare as "Team Umizoomi" until showers are done and I'm ready to slit my wrists.

After getting hosed for $100 (and that was cheap by Vegas standards, obviously) at a mediocre buffet last night, we were in no mood to try another. So we took the kids to McD’s for breakfast. The 4 bags they gave us seemed a little unusual for the 5 items we’d ordered, but I took them and wandered back to the table... Where Mrs. Grumpy discovered that, in addition to our regular order, we’d been given 27 orders of hash browns.

If you’re a McD’s shareholder who lost money on the error (or an Idaho potato farmer who made some) I must say it was unintentional and not my fault.


This is the lobby carpeting at the Excalibur. It’s a meaningless design, unless you’re a neurologist. Then it looks like a drawing of a nerve cell releasing packets of neurotransmitters across the synapse.






In a sign that all rock groups eventually sell out, the Excalibur is building "Lynard Skynard's Barbecue" (Freebird chicken sandwich, anyone?). Not that I have anything against selling-out. Hell, someone, please, buy me.


Today we went to Hoover Dam, then walked up to the new bypass bridge. It’s a helluva view, and you realize that if an oncoming semi-truck goes out of control, you have a choice between its grill or the canyon 900 feet down.





And here, from the top of Hoover dam, are (left to right) Craig’s hair, Craig, Frank, and Marie. Although you can’t see the line, Craig and his hair are in Arizona while Frank and Marie are in Nevada. And, as I said last year, all 3 are disguised as part of the Federal Witless Protection Program.

Shortly after this was taken Craig asked to leave because the wind was messing up his hair.

Then a fight broke out, because we'd all been in Nevada for a few days, but only Craig had been in Arizona (which was, say, a foot away). So Frank and Marie had a confrontation over who got to be the 2nd Grumpy child ever to go in Arizona, which ended when I pushed them both across the state line. Then they argued over who got to come back to Nevada first (it's a painted white line on the sidewalk, FFS!).

After all, one of the inalienable rights of siblings is that of fighting over stupid shit.

We talked about doing the dam tour, but the boys refused to go because it didn't include the room where they keep the Transformers.

On the drive back from the dam, the kids wanted to stop for lunch. After the fight on the dam I just opened the cooler and handed them a bunch of leftover McD's hash browns.

After getting back to the Excalibur, the kids and Mrs. Grumpy went down to the pool, and I went to play blackjack (I won $15). As I was sitting there... it happened.

Mrs. Sawme: “Hey! It’s Dr. Grumpy! What are you doing here?”

Dr. Grumpy: “Oh, Hi, Mrs. Sawme. Funny to see you here.”

Mrs. Sawme: “That surgeon you sent me to for my corroded artery...”

Dr. Grumpy: “Carotid.”

Mrs. Sawme: “Was awesome! Look at how well my scar is healing!” (rolls down shirt collar).

Dealer: “Sir, were you going to bet on this hand?”

Dr. Grumpy: “Uh, no. I, um, need to go.”

Dealer: “I understand.”

Mrs. Sawme: “Bye, Dr. Grumpy! Hey, do you know when my next appointment is?”

Dr. Grumpy: “No, call Mary. It was nice seeing you.”

Tonight, amidst much wailing and gnashing of teeth, we dragged the kids to see the Bellagio fountains “Dad! It’s just water.” And then the music started, and they shut up.

I lost the $15 bucks back to the Mirage. And they don’t even have the cool white tigers up front anymore. That sucks. Between that and the manatees the world is just going to hell on a handcart.

Summer Vacation, Day 8

Today we drove to Las Vegas. For a city that has less than 10 years of water left at their current use rate, they seem to be doing a lot of building.

We’re staying at the Excalibur. After getting up to our room on the 18th floor, the kids looked out at the strip and saw one of those mobile billboards drive by. Frank yelled, "Dad! There's a sign that says 'Hot Babes' and has naked ladies on it! What kind of town is this?!!!"

It’s Vegas, kids. What happens in Vegas... stays on Facebook.

People complain about the silent guys who try to hand you hookers' numbers as you walk down the strip. At least they aren’t pretending to be anything other than sleazy guys handing out call girl info. What REALLY grates my crank are the people crawling all over the hotel lobby trying to sell you a time-share.

They ask “Just get into town?” or “where you from?” or “How many days you here for?” The fact that they're dressed as hotel employees gives them just enough credibility that the first time it happens you answer them. Then they corner you, talking quickly about the great deal on show tickets they can get IF you spend the next morning listening to a time share presentation. They use high-pressure sales tactics ("these tickets could be gone in a few minutes, so better buy them now! If you go back to your room to check your schedule you'll probably miss them!") that make car salesmen look tame. Even more irritatingly, they try to get your kids involved “Hey, kids, I can give you some free stuff if you can get your parents to listen to me”.

After checking in we headed down to Circus Circus.

The Planet Hollywood hotel has a big "ph" sign at the top. With my chemistry degree all I can think of is the measure for acidity.

We passed signs advertising the “Frampton Comes Alive! 35th anniversary tour," showing his iconic picture from the 1976 album (but no updated ones). I found myself thinking that perhaps the tour should be called “Frampton Still Alive!” and imagined how his previous hits would sound today in Las Vegas:

“I want yoouuuuuu
To show me the waaayyyy
To the $9.95 all-you-can-eat early bird buffet.

“I want yoouuuuuu
To show me the waaayyyy
Back to my room 'cause I forgot where I stay."


We spent most of today at the Circus Circus AdventureDome park, which was a lot of fun. The hotel has seen better days, but the amusement park is still pretty good, with a decent rollercoaster, log flume, and other rides. It’s $27 for all day rides, which is a helluva deal when you consider the 2-minute roller coaster at the New York New York is ripoff-priced at $14 per person per ride (admittedly, if we went to a time-share presentation they could have given us tickets for only $10/person).

After I’d had enough of the roller coaster I bought a beer and sat down to watch the kids on a stomach churning ride. As I relaxed a homeless guy who’d somehow escaped security came up to me. I assumed he was going to ask for money, but it was even worse:

Homeless guy: “Hey!”

Dr. Grumpy: “Yes?”

Homeless guy: “Can you pour some of your beer in my cup?” (holds up unwashed coin bucket- with a few quarters in it!)

I told him he didn’t want my germs and walked away.


Craig and Frank wanted to play laser tag with me, and so we went in. It was the usual darkened room made to look like a seedy alley (granted, this was on the strip, so maybe it really was a seedy alley). To keep your nerves on edge during the game they blasted high tension-music overhead: Phil Collins’ & Duran Duran’s greatest hits of the 80’s. (REALLY!). Because nothing makes you want to shoot at another person more than listening to “Invisible Touch” at 200 gigadecibels. That and having Craig stop shooting to ask if his hair looks okay.

Right now the buzzword in Las Vegas (instead of artisanal) is “ultra”. Drives me nuts. The MGM has an ultra-lounge and ultra-pool. A local magic act is billed as an “ultra-magician”. If this catches on nationwide I’ll be ultra sick of it.

One of the funniest rip-offs here are the oxygen bars in the lobbies, where you see people paying $10 and up to breathe oxygen. Considering I've been inhaling it for free for over 4 decades I didn't see the point, but they sure had plenty of suckers customers. A sign advertised oxygen as being effective for headaches, back pain, fatigue, sinuses problems (sic), and others. It didn't say anything about it's real value as being the terminal electron acceptor in the respiratory chain, and Mrs. Grumpy threatened to kill me if I tried to argue with the 17 year old girl at the counter.

They were also selling plastic bracelets that claimed to shield you from cell phone radiation. When Mrs. Grumpy wasn't looking I asked the girl if she had some data to back up the claim, and she said "because my boss told me they do."

And that's the way it is.

Summer Vacation, Day 7

Today we loaded up the rental van for the drive to Nevada.

I haven't seen this road sign in a few years, but it was always one of my favorites here. I hadn't thought of it until someone recently sent it to me:





After we got on the road, we noticed a piece of paper tucked under a windshield wiper. At 75 mph it blew loose. plastering itself for a few seconds across the driver’s side. We had a brief glimpse of “GOT JESUS?” spread across windshield bug stains before it blew away into the desert.

During the ride we passed through an area with a previously unknown weather phenomenon. Every few miles was an electronic sign flashing "DANGER! HIGH WINBS!" I can only assume this rates with frost heaves as a serious event.

Road trips are always interesting. You see advertisements for movies you never thought of, such as “The Romance and Sex Life of the Date” sponsored by Shield’s Fig & Date plantation. We also saw signs for a place in Nevada selling “Fresh Alien Jerky”.


We stopped in rural Nevada to visit Mrs. Grumpy’s 95-year-old grandfather. Marie asked him for some water, and he brought her a cup. He than launched into a story about how, when he was her age, they used to get his family's water from a pond that always had sheep shit floating on the surface.

After hearing this charming tale Marie stared at her untouched water glass for a minute, then said "Grampa, do you have anything that comes in cans, like Diet Coke?"

I genuinely like her grandfather. He’s an intelligent self-made, self-educated guy. He’s also pretty much blind now. So when other family came over to his place to greet us, we noticed how they carefully avoided using his plates and utensils for dinner (they brought their own disposables). Upon examination I discovered that the majority of his dishes had things encrusted on them. Trying to be helpful, I began washing them, only to be told not to since it offended the man. So I settled on finger-foods, too.

While reviewing the pictures from the beach I found this one of a sand castle washing away, which someone took when I wasn't looking. And that's all I'm going to say.





After dinner we were out for ice cream with some cousins when my cell phone rang. It came up as the ID for Dr. Brain's (my call partner) office.

Dr. Grumpy: "This is Dr. Grumpy."

Maxine: "This is Maxine, with Dr. Brain's directory. He'd like you to do a consult for him at Local Hospital."

Dr. Grumpy: "I'm not on call. He is."

Maxine: "Well, our schedule says that, too. But he was quite adamant that you are tonight, and told us to call you."

Dr. Grumpy: "I'm in Chickenranch, Nevada."

Maxine: "What are you doing there?"

Dr. Grumpy: "I'm on vacation."

Maxine: "Why would you go there for vacation? Isn't Vegas nicer?"

Dr. Grumpy: "I have in-laws here. Look, the bottom line is that I'm far away, and I'm not even on call."

Maxine: "Does that mean you can't do the consult?"


We've camped out tonight in a remote relative’s basement (at Mrs. Grumpy’s insistence, she didn’t want to offend anyone). Normally cousin Eddie uses the basement to store his unfinished projects. Unfortunately, his hobby is taxidermy. So we're spending the night staring at partially-stuffed deer, elk, and bighorn sheep, who are staring back at us.

Sweet dreams.

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