Weekend reruns

This afternoon I saw a great little old lady, sharp as a tack, who got dragged in by her overprotective daughter, and was NOT happy about it.

The daughter was one of those huffy types who tried to answer every question for her mom, even though the old lady was clearly fine, independent, and a helluva lot brighter then her offspring.

Mom tried to talk around her, but the daughter just wouldn't let her answer my questions, even when asked directly of the patient.

Finally, when her daughter interrupted her for the millionth time, Mom looked at me and said, "You'll have to forgive my daughter. Normally she wouldn't be accompanying me to doctor visits, but 52 years ago my diaphragm broke."

Of Flies and Men

Okay, for those of you live under a rock, you missed THE BIGGEST SCIENCE STORY OF THE DECADE yesterday.

Now, we humans are what biology types call vertebrates. Like birds, snakes, fish, turtles, and horses, we have spines.

Invertebrates is the really big group out there (97% of animal life on Earth). It includes flies, spiders, lobsters, coral, squids, and lots of others.

From what we know, we branched off from them roughly 535 million years ago. So with our last common ancestor being PRETTY OLD, you'd think we wouldn't have a lot in common.

But, apparently we do.



(Drosophila, by the way, are flies)


As published in the journal Science yesterday, if you take a bunch of horny male fruit flies, and deprive them of female companionship, they turn to consuming alcohol as a coping mechanism.

Now, anyone who knows a guy, or is a guy, is aware that this behavior clearly exists in human males, but it's interesting to find it in a life form fairly different from ours. Of course, I'm not sure if this has been tested in closer relatives, like dogs or chimpanzees. So it's possible this is some odd vestige left from 535 million years ago that's persisted in only 2 species.

Granted, I think it's unlikely there were any bars open then (although one near Big State University when I attended it may have been, as I don't think the bathrooms had been cleaned since trilobytes had used them).


I'm left with a few questions:

1. Is this where the rejection line "buzz off" originates?

2. Do flies have flying-insect-based porn flicks to turn to? If so do they feature stars with names like Jenna Erecta?

3. Who the hell thought of studying this in the first place? Where did they get funding? And how did they keep a straight face while asking for a grant?

4. Does this somehow relate to the fact that fruit flies have the longest sperm on Earth (2.3 inches each sperm! I SWEAR!)*

5. If the sexually satisfied flies are the ones hanging out on dog shit, and the deprived are the ones getting shit faced, which is worse?

6. Did anyone do this on female flies? When sex-deprived do they go shopping?


And last, I should add Mrs. Grumpy's comment that this proves males are a lower state of evolution than females, and simply haven't changed much in 535 million years.


* If knowing this fact ever helps you win millions on Jeopardy, please remember who told you. I take Paypal.

Phone bill

Mr. Library: "Here, I brought in several articles about my condition that I downloaded off the internet..."

(hands over 3-inch-thick notebook)

Dr. Grumpy: "Okay."

Mr. Library: "And here are the office numbers of their authors. As you can see, they cover several major universities around the globe. I'd like you to call and discuss my case with all them."

Mrs. Bojangles

One of my elderly patients has just gone downhill recently, and for the life of me I couldn't figure out why.

So I had Mary bring her in.

I learned that for the last 12 years she based when to take her medications on when her dog asked to go out and pee, which was apparently pretty regular.

The dog died last month. So now she doesn't remember to take her pills.

I wanted to cry.

Mary's desk

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

Mrs. High-Maintenance: "Yes, I need to make a follow-up appointment with Dr. Grumpy."

Mary: "Okay, we can see you tomorrow, at 1:15 or 3:30."

Mrs. High-Maintenance: "No, that won't work. I can only do 10:30 in the morning."

Mary: "All right... What about Friday at 10:30?"

Mrs. High-Maintenance: "Oh sorry, it has to be a Thursday. I work at our downtown office near you every other week, so I guess that would mean a 10:30 only on Thursdays that fall on odd-numbered dates."

Mary: "Hang on... Well, the next time we can see you then would be, um, Thursday, April 5."

Mrs. High-Maintenance: "I need to be seen sooner than that! Can't you just re-schedule someone else?"

Mary: "No, we can't do that. It's not fair to other patients."

Mrs. High-Maintenance: "Well, you could be more flexible."

Today's featured item

Yes, the product you've all been waiting for: Now a starving vegan can eat her own purse, and not feel guilty about it!

(click to enlarge)





It's made from "animal-friendly faux leather" (i.e. PLASTIC).

By this standard cell phones, pens, and credit cards are now part of a well-balanced non-animal-product diet.

I should also note that anything called "Sacs of Life" brings a different kind of bag to mind.

Thank you, Kim!

Fax machine fun

Dear Dr. Talus,

I'm sorry your patient's cheapshit insurance doesn't cover podiatrists.

But that doesn't mean I'm going to start doing foot surgery.

I'm a neurologist. So please stop sending referrals like this to me.





Thank you,

Ibee Grumpy, M.D.

Love and marriage

Dr. Grumpy: "When did you call paramedics?"

Mrs. Leg: "Let's see... the numbness started around 10:20, and by 10:30 the leg was very weak. I couldn't use it to stand or walk or anything, so I asked Bill to dial 911."

Dr. Grumpy: "That's when they were notified?"

Mrs. Leg: "Well, no. He got up and brought me the phone during the next commercial break, then I called."

Sunday rambling

I've touched on this before, but after getting dragged to "The Lorax" today (and no, I didn't like it. The 1971 book, or 1972 TV cartoon, were far better and more to-the-point) I noticed the same issue.

When I was in high school Quiet Riot released a cover version of Slade's "Cum On Feel the Noize" that was a smash hit. It also got censored (at least where written displays of its title were shown) because of the first word's spelling. So in stores you'd see the single (yes, folks, 45 rpm) with an attached piece of paper saying "Come" partially covering the name.

And today, where is this obscenely-spelled piece of music being used? In a movie trailer for "The Pirates! Band of Misfits" a children's claymation film cumming, I mean coming, out this Spring.

In another preview was the less controversial (unless you're Harold Camping), but still very 80's, REM song "It's the End of the World as We Know It (and I Feel Fine)" being used in the trailer for "Ice Age 4: Continental Drift".

So, the take home messages from the movie today are:

1. Any book that takes less than 20 minutes to read is unlikely to be made into a decent movie. They simply have to add WAY too much extraneous material. And this usually includes a few musical numbers.

2. The 80's will never die. Music, leg warmers, and all.

Random Sunday pictures

First off we have this post-holiday sale on "Christmas Deluxe Chanukah Candles."





Next we have this dumpster. I'd like to see the opposite, a company called "Inaccurate Trash Removal," that randomly hauls off your car, patio furniture, kids, etc.






Here we have a marketing survey on coffee, asking if people like it to be called "artisanal."





And (my favorite): if you can't afford the new iPad, or even a used one, there's this device. It's battery life is virtually inexhaustible, it can be carried anywhere, and is cleverly made from organic materials to help conserve metal.





To operate the gadget you'll need a special stylus...

Weekend reruns

I'm tied up with kid stuff today, so thought I'd re-post one of my favorite historical oddities. If you enjoy this sort of trivia, please check out my collection of history posts.






In 1941-1943, the Axis U-boats dominated the Atlantic, and the Allies were looking for an answer. The airplane was an effective anti-submarine weapon, but the logistics of using planes in the Atlantic were daunting. Aircraft carriers were urgently needed in the Pacific and Mediterranean. Land based planes' range was limited, and could only cover portions of the Atlantic. So there existed a "black gap" in mid-ocean, where the U-boats could roam at will.

So the naval staff of Britain came up with a remarkable idea, which was named Project Habakkuk: to build a gigantic aircraft carrier out of ice. And, as crazy as it sounds, it may have worked.

Normal ice shatters, and melts. A British engineer, Geoffrey Pyke, developed a mixture of ice and wood pulp called Pykrete. The new material was surprisingly resistant to blunt force. As temperatures rose, the wood pulp formed a fuzzy coating over the ice, insulating it from further melting. Experiments on Pykrete were conducted in top secret, in a refrigerated meat locker beneath Smithfield meat market in London. Frozen animal carcasses were used to hide the research areas.

The size of these ships would have been remarkable. The initial design was for a floating airfield 5000 feet (1524 m) long, 2000 feet (610 m) wide, and 100 feet (30 m) high. Later designs were shortened to 2000 feet long. They would have a displacement of 1-2 million tons. By comparison, the huge aircraft carriers in use today by the U.S. Navy are just under 1100 feet long and weigh 101,000 tons.

They could handle the biggest planes of the era, and carry enough food and fuel to resupply them for months. They had externally mounted power plants capable of propelling them at 6 knots, and would act as floating airfields in the North Atlantic. They were cheaper, and could be built much faster, then a conventional carrier, and had an estimated lifespan of 6-18 months (likely longer, as it turned out).

To see if the idea would work, a 60 foot scale model was built at Patricia Lake, in Canada, over the winter of 1942-1943. To preserve secrecy, the Pykrete blocks were made at Lake Louise, and moved to Patricia for assembly. And it worked quite well. In Summer the wood pulp covered the ice and slowed the rate of melting. Auxiliary cooling equipment was developed that could be carried outside the hull.

Churchill thought quite highly of the idea. The ships would be built in Canada, and to this end the Canadians began assembling enough ice and wood pulp to begin construction.

More and more technical problems, however, came up, and by the time they were sorted out the tide had started to turn against the Axis. The Liberty ships were being built faster than U-boats could sink them. The Allies had developed small, relatively cheap, escort aircraft carriers, which were now providing air coverage to Atlantic convoys. Long range patrol bombers had improved. And so one of the most remarkable ideas in naval history was quietly shelved.

The model built at Patricia Lake took 3 years to melt, showing that Pykrete was quite durable. It was allowed to sink into the lake.

And there, at the bottom of Patricia Lake in Alberta, Canada, lie the remains of Habakkuk. The test ship's frame, with a small motor and refrigeration plant, are now visited by scuba divers. Jasper National Park receives many visitors every year, most unaware that at the bottom of a small, serene, lake is all that's left of this remarkable idea.

Home

Dr. Grumpy: "Hey Craig, how did you do in the class debate?"

Craig: "I did okay. I'm the first alternate for my class debate team. So if another kid, like Jeff, gets sick than I'll be on the team."

Dr. Grumpy: "That's great!"

Craig: "Since you're a doctor, can you write me a note to take to school tomorrow? Something that says Jeff is sick, and can't participate?"

Nudge nudge wink wink

Dr. Grumpy: "It looks like you have carpal tunnel syndrome."

Mr. Arm: "I can believe it. I've been doing the same repetitive motion with my right hand every day for 39 years."

Gone with the Wind

While picking up the kids from school on this blustery day, I overheard two women having a shouted conversation in the parking lot:

Mom 1 "BOY! IT SURE IS WINDY TODAY!"

Mom 2: "WHAT?"

Mom 1: " I SAID, BOY, IT SURE IS WINDY TODAY!"

Mom 2: "I CAN'T HEAR YOU! IT'S TOO WINDY!"

Snort

The DATscan is a test used for assessing patients with unclear types of tremors. Like many other tests, there are some medications you have to stop a day or two in advance.

So the guidelines include a helpful list of all such drugs, and their time frames.





I personally like this one:




"Hey, Phil, in order to take the test, you need to stop hitting the blow for 2 days."

Language

While on call this past weekend I discovered this line in another neurologist's note:

"An ictal event is possible, and cannot entirely be excluded, however our data to implicate such process definitively is somewhat tenuous at this point in time."

Care

Dr. Concerned Internist: "Hello?"

Dr. Grumpy: "Hey, Susan. It's Grumpy. I need to talk to you about Mrs. Aspirin."

Dr. Concerned Internist: "What's up?"

Dr. Grumpy: "Well, you referred her to me for a TIA, so I ordered a carotid ultrasound. Her arteries look okay, but on one side she's got a small thyroid nodule, and the radiologist is worried it's malignant."

Dr. Concerned Internist: "So why are you calling me?"

Dr. Grumpy: "Well, it needs further work-up, and you're her internist."

Dr. Concerned Internist: "You ordered the test that found it, so it's your problem now."

Click

Artisanal mailbag time

First up, from the land down under, (proving the insanity isn't confined to one hemisphere or continent) we have this company:





I can only assume that artisanal air is composed from handcrafted Australian atoms of hydrogen, oxygen, and nitrogen, rather than, say, made 13.7 billion years ago during the big bang.




Next is this, which came up as the error message when the page crashed. So the IT guys are now officially artisans.







Now we have this picture from Las Vegas, advertising a local strip bar.





I suppose in some way the strippers are artisanal, as their chests were handcrafted by some of the finest plastic surgeons in Tijuana.

By the way, your cab driver is asleep.



And lastly, we have this, from CakeWrecks. While not claimed as artisanal, it deserves to be shown. Because, as a neurologist, some things just call for a nice piece of cake.





And that isn't one of them.

Memories

Recently my colleague Sufu, who's in medical school, emailed me about the issues with learning to hear heart sounds.

It brought back memories of a lecture I had back in medical school, when a cardiology professor delivered these helpful quotes:

"This type of murmur sounds like a snowflake landing on a feather."

"You can practice mimicking heart sounds by tapping on Kleenex."

"If you think you heard this murmur, you didn't."

"I've never heard that heart sound, so I don't believe it really exists."

"If you can imagine the sound dandelions make as you blow seeds off them, you should be able to hear this murmur."

Looks like you're on the couch tonight

Mr. Lumbar: "When the leg pain gets really bad it makes driving unsafe."

Dr. Grumpy: "Why? Does the leg get weak?"

Mr. Lumbar: "No, because then my wife has to take the wheel, and she's dangerous."

Law and Order

Today's legal tip:

1. In a criminal case, you should have an attorney represent you, and not do it yourself.

2. If you do it yourself, and lose, you should not try to appeal on the grounds that you were incompetent at doing so.

Thank you, Officer Cynical!

Mary's desk, February 29, 2012

Mr. Irritant: "Hello?"

Mary: "Hi, this is Mary, calling from Dr. Grumpy's office. Your MRI is back, and so I'm calling to schedule your EMG."

Mr. Irritant: "Did he tell you that? Or are you just wanting him to do the test?"

Mary: "He told me to schedule it, sir. He says that the MRI didn't show a cause for your arm symptoms, so he needs to do an EMG to see if there's any damage in the arm itself."

Mr. Irritant: "Can he get on the phone himself and tell me this? I don't trust you desk people."

Mary: "I can have him call you later, but he's with a patient right now."

Mr. Irritant: "I want to hear it from him. I know you desk people work on commission based on tests you schedule."

Today's criminal tip

After you attempt to rob a bank, don't immediately go back to use the ATM.

Thank you, Tanya!

Good to know

Mrs. Definite: "My father died of prostate cancer. But I'm trying not to worry about it because my gynecologist reassured me I don't have one."

Great outdoorsmen

Somehow I don't think it was planned like that.

More from drug companies

This picture:

(click to enlarge)




A. Is an ad for "Monsters vs. Aliens 2"

B. Shows that evil robots and pastel dragons are now approved in the U.S.

C. Makes you wonder what Dr. Grumpy has been smoking.

D. Oh crap, not another Pokemon movie. My kid has enough of that shit already.

E. Is the reason I shouldn't eat grumpyberry pie and ice cream before bed.

F. Is an ad for an epilepsy drug.

Euphemism

Dr. Grumpy: "Any problems on the new medication?"

Mr. Von Braun: "I can raise the missile, but can't launch a warhead."

Money well spent

Mr. Mercury: "I'm always concerned about my blood pressure. I have a blood-pressure machine at home, and I even travel with it."

Dr. Grumpy: "Where do your pressures usually run?"

Mr. Mercury: "I don't know. I've never used it."

Great captcha moments

While commenting on another blog recently, I got this verification word:






I'm trying not to take it personally.

Memories...

One year we returned from vacation a day early, because of a problem with one of our dogs. My parents had taken him to the vet for us, and Mrs. Grumpy wanted to rush home and get him (he was her baby).

The vet's office was closed for the weekend when we got back, but they'd told us the 20-something girl who stayed with the pets overnight would let us in to get Fido, since it was a special circumstance and we were established clients.

Anyway, we came by, and she let me in to get the dog. I had some questions, and was talking to her in the lobby for a few minutes. Her shirt was on inside-out, but I didn't pay much attention to it until a naked guy came wandering out of the back and said, "Hey, don't leave me hanging... Oh, sorry" and ran back.

She blushed. I took the dog and left.

Dr. Grumpy at his finest

A while back I was called to the hospital to see a guy with a stroke affecting his language cortex. He wasn't able to talk at all. He didn't have any weakness or other issues, just couldn't speak.

It was a pretty notable stroke on MRI. I spent some time talking to his wife, then went home.

The next day I was absolutely shocked when I was on rounds, and he got in the elevator with me! He looked great, was dressed in his street clothes, and I began talking to him. His speech was excellent. It was the most remarkable recovery I'd ever seen in such a a short time.

It was the patient's identical twin brother, coming to visit him.


I'm legendary for my stellar performances on rounds. This was another one.

Oh for hell's sake!

Thank you, Caya!

Probably me, someday

Mrs. Carehome: "A friend of mine is a doctor, and he wrote down some questions for you about my condition."

(hands over a folded piece of paper)

Dr. Grumpy: "Ma'am, this makes no sense. It's just a random jumble of words and letters, and they don't relate to anything. Are you sure your friend is a doctor?"

Mrs. Carehome: "The nurse said he used to be. We both live over at Shady Hills, though he's in the Alzheimer's unit."

Neat trick

Dr. Grumpy: "What do you do when the hand goes numb?"

Mr. Palmer: "I take out my neck and adjust it."

Things that make me grumpy

Doctor Grumpy's vote is worthless every 4 years.

That doesn't mean I don't vote for President- I always do. And almost every other election that comes up.

Every political system has it's quirks. And this one is a real pet peeve of mine.

To give some background for my non-U.S. readers:

The American political system started, like most, in an era when horses were the main method of transportation, and hence long-distance communication of news. So it wasn't practical to count every single nationwide vote in Presidential elections every 4 years (there were other issues for the electoral college, but I'll let commentators fill those in).

Each U.S. state was given a certain number of votes in an electoral college, based on how many congressional representatives it has. In this system, whichever candidate gets > 50% of the vote in a state gets ALL that state's electoral college votes. It's all-or-nothing. To be fair, a few states have tried to remedy this, by splitting up electoral votes by districts, or based on percentages of popular votes. But for most, it's still all-or-nothing.

So 3 times in American history the winner of a Presidential election was NOT the person who won the majority of the popular vote.

Now, in an era where you had to tabulate votes locally, and send the results by horseback, this system made sense. But with the invention of the telegraph, and then the radio, telephone, and internet, it's not needed. The technology is now there to count every vote, which certainly would be fairer.

So, since Dr. Grumpy lives in a state where he's in the political minority, his Presidential vote is meaningless. All my state's electoral votes go to the other side.

The practical result of this is that, out of the 50 U.S. states, only 10 or so really are the ones that elect a President. They call them "swing states", where they have a large number of electoral votes AND a population that's fairly evenly split. And so politicians only focus on kissing ass in those areas, and ignore the other 80% of us.

Now, most Americans hate this crap. Polls taken regularly since 1944 have shown that a large majority of Americans want to toss the electoral college and just go to direct election by popular vote.

Has this ever even come close to happening? Hell no. Why not, you ask?

Because it's not in the best interest of any major political party!

Let's look at this: Say I'm Humungous Political Party, trying to get my bozo elected. I have a finite amount of money to blow on TV ads, public rallies, etc. Say, (for simplicity) it's $100.

In the current system I can focus that $100 on the 10 states where it matters (at $10/state), and ignore the rest of the voting peons all over the country.

But, if the electoral college were gone, then every single vote, from populous New York to rural Alaska, becomes equal. I'd have to spread my resources thin and blow only $2/state trying to reach everyone with a ballot.

No political party wants to do that. They want to focus their dollars on a concentrated area, getting the most returns for their spending.

You can write to your congressman all you want. He'll agree with you, then vote the opposite way. Multiple attempts to change this have been introduced, and all were killed off early.

After all, voting equality is so un-democratic and un-American.

Bring me Haldol STAT! Oh, and a banana.

What do the CIA, Elvis, a former President, and orangutans have in common?

This guy, apparently.

Thank you, Tanya!

Patient quote of the day

"Doctor, I really want to know if I have something. Because if it's anything, it would probably be something. And I want to know if it's something. If it's nothing, then that's not anything, but I need to know if it's anything like something or nothing."

Jerry Springer meets Dr. Grumpy

Sermo is one of many online medical communities. I tried it a few years back, but deleted my membership out of boredom. I'd never written any posts, and got tired of the daily emails on such controversial topics as "doctors should provide patient care," "we all want to make more money," and "hospitals are for sick people."

Anyway, apparently they've livened things up (or it was online sweeps week) because my reader Sally sent in this headline, which was a "Sermo Pick" last week (on Valentine's Day, no less):

(click to enlarge)





This was, actually, a tragic story. A married doctor (Hyo Shin, age 64) had been having an 18-month affair with Sarah Garibay (age 29) a lady he met at a strip bar, and became her "sugar daddy". He died after her other sugar daddy (Jeff Clay, age 49) walked in on them at an inopportune time and beat Dr. Shin. The doctor then jumped out a window to escape, and eventually died from his injuries. Clay has been sentenced to 12 years for voluntary manslaughter.

In a surprising twist, the late Dr. Shin's wife told the court that her husband had "a high moral standard and would not stand for one speck of immorality."

The wife of the convicted Mr. Clay testified that he was "hard-working and non-violent", and that she still wanted him to come back to her even though he'd been seeing 2 other women and using methamphetamine.

Another story noted that Miss Garibay (who denied being a prostitute) testified in court while "wearing a short skirt and low-cut top." She said she "immensely" loved her married boyfriend Clay, and was "hurt" that he subsequently tried to hire a prison inmate to kill her, too.

Anyway, I asked some of my colleagues about their takes on this story, and they had a few pointers:

1. Don't date people you meet at a strip bar.

2. If you do, let the buyer beware.

3. At 64 you should know better.

4. Avoid sugar daddies on meth.

5. There are worse obituaries to have, but not many.

6. Isn't there anything better to do in Yuba City?

Nice haircut, though

Look: Even if you're in a wheelchair, that doesn't give you a license to be a crook.

And if you're going to rob a convenience store, at least have a decent getaway plan.

Thank you, Don!

We have a winner!

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

Mr. Florida: "Yeah, I'm a patient of Dr. Cortex, and I left my medicine back in Grumpyville. I'm visiting family in Orlando."

Dr. Grumpy: "Okay, do you have a pharmacy number there?"

Mr. Florida: "Um, no. Do you recommend any pharmacies near my hotel?"

Dr. Grumpy: "Sir, I have no idea what's there. Why don't you look around the area you're in, or ask someone at the hotel desk?"

Mr. Florida: "Am I allowed to do that?"

Dr. Grumpy: "Yes."

Mr. Florida: "Do you know what medications I'm on?"

Dr. Grumpy: "You mean you don't?"

Mr. Florida: "I told you, I left the bottle at home. I think it was in milligrams. Does that help?"

Dr. Grumpy: "Do you have a way of looking them up?"

Mr. Florida: "Of course. I keep them all on my iPhone."

Dr. Grumpy: "Where is that?"

Mr. Florida: "In my hand. I'm talking on it."

Guest post from Officer Cynical

Today, February 19, 2012, marks the 67th anniversary of the Marines' landing on the island of Iwo Jima. 70,000 U.S. Marines and support troops went ashore against 22,060 entrenched Japanese.

On March 26, 1945, when the island was declared secured, 6,812 Americans (10%) were dead or missing, and an additional 19,217 (27%) had been wounded. Of the defending Japanese force, only 217 were captured. The remaining 21,844 (99%) were killed.

27 Medals of Honor were awarded (13 posthumously) - over one-fourth of all the MOHs awarded to Marines in all of WWII.

I recently had the honor of meeting an Iwo Jima survivor at an assisted living facility. He summed it up this way: "The Japs would not surrender. They wouldn't come out of their caves. So, we burned them out with our flamethrowers, then shot them with our rifles. It was awful".

The picture I've included is not the one you might expect - the flag-raising on Mt. Suribachi. Rather, it is a landing craft of "average" Marines, most in their 20's, throwing themselves into the raging inferno, despite their fears and trepidations. Home must have seemed like a distant planet. We owe them everything.

Sunday reruns

Must be a full moon. Today I had some of the following exchanges with patients:


Dr. Grumpy: "I'd like to see you back in a month".

Ms. X "I'll be here. Unless, of course, the Lord comes before then. He is coming soon, you know."





Dr. Grumpy: "How's your physical therapy been going?"

Ms. Y: "I stopped going because angels have been surrounding my bed at night to heal me."





Dr. Grumpy: "How long have you been seeing Dr. Smith for your heart problem?"

Mr. Demented Psychotic: "Since he raped me in prison".

(for the record, Dr. Smith has never been in prison, nor raped anyone, that I am aware of)

More artisanal crap

Okay, my intense hatred of the overused word "artisanal" (and its derivatives) is pretty well known.

But this one is thoroughly annoying:





Let's look at this:

1. It uses the word "artisan" twice. Once to make you nauseous, and once to make you puke.

2. It's a FREAKIN' JAR OF HONEY PEOPLE! Humans can't even make it.

3. The "Artisan honey keepers" are BEES! I'm pretty sure they aren't making this claim, any more than my dog claims to be an "artisan shitpile keeper."

4. If you're going to put a "gluten free" label on honey, maybe it's time we started putting "fat free" stickers on water.

Trivia answer

Earlier this week I used the term "Hufnagel's Syndrome" in a post.

It wasn't meant to get any sort of attention, I just needed to come up with a disease name.

To my surprise, my stats have since shown a surprising number of people googling "Hufnagel's Syndrome" trying to find out what it was, then being directed back to the post. I've also received about 20 emails asking about it.

So here is the answer: There is no such disease.

The name idea is from a TV show I grew up watching, St. Elsewhere, set in a teaching hospital.

Florence Hufnagel (played by the mostly forgotten, but truly awesome, Florence Halop) was a recurring character. She was the classic patient-from-hell that we all encounter during our training (I didn't realize how accurate her portrayal was until I did my residency 10 years later). She was comically abusive and sarcastic, and made you realize how hard it could be to try and take care of someone you couldn't stand.

Her character made such an impression on a generation of TV watchers (and future doctors) that as recently as 2010 she was being cited in the news as an example.

In one of the most memorable scenes in TV history, Mrs. Hufnagel died from a bizarre combination of cardiac surgery complications and (more importantly) a malfunctioning adjustable hospital bed. It folded up into a V shape, bending her in half and suffocating her. Her death scene showed only one arm, sticking straight out the side of the folded bed.

In a bizarre postscript, it later turned out that she'd left her entire estate to one of the residents (Elliot Axelrod). When he met her lawyer it was (roughly) $50,000, but with taxes, funeral costs, and "an ongoing legal action with American Samoa" it left him with something like $18.73.

So, if you really want to think there's a disorder called "Hufnagel's Syndrome," I suppose it would be being killed by an electric adjustable bed.

Mistaken identity

While he's spending time in Juvenile Detention, I hope this kid gets some botany lessons.

Thank you, Nurse Kitty!

No kidding

This is a drug ad I saw in a journal recently:





What makes it great is the line at the bottom:

Medical research

A number of studies have addressed withdrawal issues, covering alcohol, tobacco, and controlled drugs. A review of the literature, however, shows a surprising lack of research into other addictions. In an attempt to rectify this situation I'm publishing the following data, addressing a transient, yet debilitating, condition.

For the purposes of assessment, and for possible use in future cases, a grading system was developed for this paper. It was based on the World Objective Zeitgeist Joint Organizational Bureaucratic System (WOZJOBS) staging scale data.


Case report:

A middle-aged neurologist recently left his MacBook Pro overnight at the Apple Store for repairs. Over the next several hours he underwent a gradual series of decompensations, which are presented here.

Stage 1: Minor inconvenience. "I can live without my computer for a few hours." Reads paper mail, realizes it's all junk advertising real estate agents, car dealers, and grocery stores.

Stage 2: Needs alternative. Finds things around house which weren't previously noticed: books, magazines, children, pets, spouse. Fingertips begin tingling.

Stage 3: Decides to go online with iPad. Discovers it was left at the office. Considers 1 hour drive through snow back into dangerous downtown area after dark to get it. Finds that spouse let air out of car tires to prevent this. Hyperventilates.

Stage 4: Tries to use iPhone to send long emails and write blog posts, discovers it's not particularly well suited to this. Sprains thumb.

Stage 5: Desperation. Diaphoretic & dyspneic. Dusts off old Windows laptop in the back of closet and is able to get online. It freezes up every 2-3 minutes, reminding him why he stopped using Windows in the first place. Blames Steve Jobs for his current state of despair. Spouse administers sedative consisting of caffeine-free Diet Coke laced with an old Vicodin tablet from the medicine cabinet.

After being sedated the subject was tucked into bed, carefully guarded by a pair of 4-legged orderlies. All symptoms resolved the following day after picking up the repaired computer.


Discussion: Computer withdrawal blows. They should be able to carry out all repairs in less than one-fourth the estimated time (like Mr. Scott) and not have to keep it overnight. Also, caffeine-free Diet Coke sucks.

"Hey, you want to land in jail for Valentine's Day?"

Okay, lovebirds, let's keep this in mind: When getting kinky, remember to keep it private.

Technology

Dr. Grumpy: "How are you doing? I heard you were in the hospital?"

Mr. Bag: "Yeah, I had a bad infection down there. They had to filet my scrotum to clean it out."

Dr. Grumpy: "That sounds awful."

Mr. Bag: (whips out phone) "Here's a picture."

Probably the T-shirt guy

Why is Papa Smurf smiling?