Sunday re-runs

On the side I do survey work for various market research companies. They ask me what I think of ad campaigns, or medications, or whatever.

So last night I was doing a phone interview with one, and was asked this great question:

"Doctor, have any of your patients ever stopped taking their Alzheimer's medication due to death?"

Random Saturday pictures

First off, we have this:

 

Because nothing says "handmade by skilled craftsmen" more than prepackaged pizza dough in a plastic tube, made by a huge food conglomerate, and stacked en masse on shelves in every grocery store in North America.



Next is this picture, taken on approaching Atlantic City. Where, apparently, the casino buildings are always standing erect and ready.

Back to the artisanal crap, we have this generic package from a generic warehouse club, where they apparently can't decide if their generic cookie of the month is blueberry, cranberry, or macadamia. Unless it has all three.

Of course, there's always artisanal salt to put on your artisanal food:

And then there's Australia, where you can build an entire pharmacy from artisanal components!

And  lastly, we have this non-artisanal, but remarkably bad, juxtaposition of news headlines:

Friday whatever

Mr. Webster: "My internist says my blood pressure is erotic."

Dr. Grumpy: "You mean erratic?"

Mr. Webster: "Whatever."

Assumptions

Mary: "Is there a problem, ma'am?"

Mrs. Ink: "Yes. I don't like having to fill out these forms with a pen tied to the clipboard."

Mary: "I'm sorry, but before we started tying them on we were losing 2-3 pens a day. That adds up."

Mrs. Ink: "Ridiculous. You get pens for free from drug companies, anyway."

Mary: "We used to, but that was banned effective January 1, 2009. So now we buy our own office supplies like everyone else."

Mrs. Ink: "Everyone knows doctors are rich. I can't believe your cheap boss just doesn't buy more pens."

The evening news

By a quirk of fate, I have not 1, but 2, items to share tonight.

1. Sometimes you may be better off to just stay in jail.

2. I don't know what to say.

Why? Why? Why?

Dr. Grumpy: "How are you doing?"

Mr. Colloid: "Fine, except this morning I was hacking up some seriously disgusting greenish-black caked mucus gunk."

Dr. Grumpy: "I'm sorry."

Mr. Colloid: "Here's a picture of it."

Steve Austin. Asstronaut. A man barely able to sit comfortably.

Technology. Bringing us the internet, iPads, digital music, MRI's, the International Space Station...

And, most importantly, the world's first BIONIC BUTTOCKS!

Thank you, SMOD!

Life on the edge

Dr. Grumpy: "Do you take anything for the panic attacks?"

Miss Old: "I don't want to. They're pretty much the only excitement I get."

Sunday night, 9:05 p.m.

Mrs. Nerve: "Hello?"

Dr. Grumpy: "Hi, it's Ibee Grumpy, calling to give weekend check-out to Dr. Nerve."

Mrs. Nerve: "He's in the bathroom."

Dr. Grumpy: "Okay, can he call me back when..."

(muffled male voice in background)

Mrs. Nerve: "He says he wants to talk to you, hang on..."

(muffled male voice in background)

Mrs. Nerve: "He wants to know if Mr. Smith is still in the hospital?"

Dr. Grumpy: "He went to the rehab floor, but Dr. Nerve will need to check his follow-up CT..."

(muffled male voice in background)

Mrs. Nerve: "Hang on, he says he's out of toilet paper."

Dr. Grumpy: "Look, I'll just call back in..."

Mrs. Nerve: "No, it's okay. He asked if the Jones girl had any more seizures?"

This is Karl

I don't know him personally. I wish I did, as he seems like a helluva nice guy. He's a hospitalist, and in our occasional communications by email or blog comments seems to be pretty cool, and a damn good doctor. He's the kind I wish worked at my hospital.

In addition, Karl is also a great cook from what his family tells me. Every year he single-handedly whips-up some sort of major-league Mardi Gras feast. Never having been to Mardi Gras I have no idea what he's cooking, but if I was invited, and lived near you, Karl, I'd definitely come over (but I'd have to draw the line at crawdads- crustaceans just ain't my thing).

As you can see in the picture, Karl's sister was also kind enough to make him a Dr. Grumpy cooking apron for Christmas.

He's also built his own wooden boat. Not a model, but a real boat. Which is way beyond what I can do. My boat-construction abilities are limited to inflating a raft for the pool.

Unfortunately, for all the fact that Karl is a good person, doctor, and cook, he's been diagnosed with brain cancer, has been through chemotherapy, and is now home on hospice.

So, Karl, this post is dedicated to you. I'm sure you helped plenty of patients and their families over the years who never had a chance to thank you.

Not to mention helped patients of other neurologists, and because of my field's inherent lack of social skills, I suspect my neurobros didn't thank you either.

Since you're now on the other side of the bedrail, I want to thank you on all of their behalfs and wish you and your family the very best at this difficult time.

I also want you to know what an awesome sister you have, and how much she loves you enough to put me up to this. Your wife is in cahoots with her.

Thank you, from all of us out here in cyberspace.

Ibee Grumpy, M.D.

July 13th rerun

His name was Girard. He had back pain. That's all I remember about him.

On July 13, many years ago, he was the very first patient I ever saw on my own.

Working without a net for the first time is terrifying. I'd survived 4 years of medical school, 4 years of residency, and 1 year of fellowship to get there. This is the goal I wanted. And when it finally came it scared the crap out of me.

There was fear in medical school, starting classes and later starting clinicals, and even more in residency. But in both those cases there was always a back-up system- more senior people who actually knew what they were doing. There was also a herd-based support system: You were with plenty of other people, all sharing the same challenges.

But here, after 9 years of training, it was just me and Girard. Even though his case was simple, it's pretty damn scary to realize that YOU are the attending, and if you screw up there's no one else to blame.

I remember another patient that day started the visit by saying "I came to Humungous Neurology because I heard you guys are the most experienced." My inner voice said "you probably don't want to know this is my first day."

Throughout medical school you saw the attending physicians as omniscient giants. Suddenly you're one of them, and realize that they don't know everything. And you aren't a giant.

Like everything else, after a while it becomes routine. But trying to remember that first day still helps to keep you on your toes.

I don't remember how many patients I saw that first day. A handful compared to what I see now. One of them is still with me. I think I told her a few years later she was on my first day. I even got a hospital consult, a lady who'd obviously had a stroke. I got lost in the hospital trying to find her room, then sat in the MRI control room to see images, terrified at the thought that if they were normal I'd have no idea what was going on.

I've now spent an estimated 4,650 days of seeing patients in one place or another, with a lot more to go. But the first one was the scariest. And hopefully always will be.

To all who are starting this July, good luck.

No, I honestly don't

"Doc, because, sometimes I get headaches, and I also have trouble remembering things, and it's like when your foot hurts, or you've just slept with a bunch of girls and don't want to get tested, or you just got a new car and repaired the roof. Do you know what I mean?"

Not tonight, I have a headache

Yes, folks, tonight is (drum roll):

I'm not joking. This is a somewhat bizarrely-named drug-company sponsored educational event where doctors can (remotely) listen to lectures about migraine pathology and treatment.

Personally, I think this could have been better named something like "Migraine Symposium." Because the current name sounds like we should all be sitting in the dark with icepacks on our heads in solidarity. And I sure as hell wouldn't want to join that.

But it's for a good cause, so let's all break out the triptans and party (no red wine or chocolate)!

I suppose one has to grateful such events aren't held for Viagra, Detrol, or Imodium.

Annie's desk, July 9, 2012

Mrs. Gemini: "Hello?"

Annie: "Hi, Mrs. Gemini. This is Annie, from Dr. Grumpy's office. He wanted me to tell you your brain MRI was fine."

Mrs. Gemini: "REALLY! That's incredible. I'm so happy to hear it. I mean, I was pretty sure I had another one in there."

Annie: "Another one?"

Mrs. Gemini: "Well, I read this thing at the supermarket checkout about how this lady had, like, her unborn twin inside her head, with teeth and hair and everything, and I figured that's what I had."

The set-up

Frank: "DAD!"

Dr. Grumpy: "What's up?"

Frank: "Can you come help me?"

Dr. Grumpy: "Where are you?"

Frank: "I'm in your bedroom, by the dresser."

I run into my bedroom and find...

  Clever little bastard.

Today's criminal tip

When trying to rob a convenience store, don't take your Mom along.

Thank you, PH!

Friday morning

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

Mr. Words: "I'm having balance problems. Like my liquoribrium is off."

Burnin' down the house

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

Mr. Prolixin: "My arms are on fire!"

Dr. Grumpy: "You mean they feel like they're on fire?"

Mr. Prolixin: "NO! THEY'RE REALLY ON FIRE!"

Dr. Grumpy: "Okay..."

Mr. Prolixin: "CAN'T YOU SEE THE SMOKE AND FLAMES?"

Dr. Grumpy: "Well, no."

Mr. Prolixin: "Ya know, neither can my psychiatrist."

July 4, 1939

"Fans, for the past two weeks you have been reading about the bad break I got. Yet today I consider myself the luckiest man on the face of the earth. I have been in ballparks for seventeen years and have never received anything but kindness and encouragement from you fans.

Look at these grand men. Which of you wouldn’t consider it the highlight of his career just to associate with them for even one day? Sure, I’m lucky. Who wouldn’t consider it an honor to have known Jacob Ruppert? Also, the builder of baseball’s greatest empire, Ed Barrow? To have spent six years with that wonderful little fellow, Miller Huggins? Then to have spent the next nine years with that outstanding leader, that smart student of psychology, the best manager in baseball today, Joe McCarthy? Sure, I'm lucky.

When the New York Giants, a team you would give your right arm to beat, and vice versa, sends you a gift — that’s something. When everybody down to the groundskeepers and those boys in white coats remember you with trophies — that’s something. When you have a wonderful mother-in-law who takes sides with you in squabbles with her own daughter — that's something. When you have a father and a mother who work all their lives so that you can have an education and build your body — it's a blessing. When you have a wife who has been a tower of strength and shown more courage than you dreamed existed — that's the finest I know.

So I close in saying that I might have been given a bad break, but I've got an awful lot to live for. Thank you."


-Lou Gehrig, terminally ill at age 36 with ALS (aka Motor Neuron Disease), in his retirement speech. He died less than 2 years later.

This post is dedicated to Spiritcove and Roy, facing ALS as best anyone can. This is likely the worst disease in neurology, if not all of medicine. It's been almost 200 years since the first published report on it, and effective treatment remains a mystery.

If you're looking for a cause to give money to, consider the ALS Association.

Things I wish I could take back

Dr. Grumpy: "So at your last visit the medication was causing impotence, and we stopped it."

Mr. Pill: "Yeah."

Dr. Grumpy: "So where do things stand now? I mean, uh..." 

Mr. Pill broke out laughing.

Things that make me grumpy

I say "epilepsy." What do you think of?

Did you think of someone drooling in a dimly lit institution? Or someone so sedated on their seizure medicines that they aren't capable of working?

Think again.

Yes, there are some patients who still fit that description. But they're rare. You want to know what most epilepsy patients look like? They look like YOU!

Yes, folks contrary to popular belief, epilepsy patients are out there living normal lives. And there's a lot of them. It's a disorder that affects 1% of humans. So imagine the Rose Bowl stadium in California. When sold out it holds roughly 90,000 football fans. And statistically speaking 900 of them have epilepsy. Some may even be playing on the field.

Current epilepsy patients in my practice include 7 teachers, 3 doctors, 5 nurses, 1 judge, 2 veterinarians, and a lot of other responsible professionals.

Very few diseases have been as maligned over time as this one has. The majority of early cultures attributed seizures to demonic possession. I'm sure many innocent epileptics were killed in horrible fashion because of this. Others saw it as an intentional punishment from the gods. The great Dr. Charcot, founder of modern neurology, reported that in 19th century France epilepsy patients were locked up in the same dark building used to house the criminally insane and mentally handicapped.

Detail from "Transfiguration" by Raphael (1516) showing a child possessed by demons. The boy's posture and eye deviation are typical of partial-complex epilepsy.

You don't have to look too far back in American history to find laws on the books that banned epilepsy patients from marrying or having children. In the mid-90's I even trained under a doctor who still believed that horseshit, and told young adults, just starting out in life, that they should never, ever marry or raise a family. That's a pretty damn devastating thing to do to someone.

Vilifying any person because of an illness is wrong, whether it's diabetes, hypertension, or cancer. But epilepsy is one in my specialty, and I'll make a stand for my patients.

I probably fight harder for the rights of my epilepsy patients than any other group. Several times a year I have to write a letter to a divorce attorney saying that a well-controlled seizure patient is perfectly capable of being a parent, because the ex is saying that it makes them a danger to kids. Or I have to reassure a family that a patient can drive, or work, or travel on a plane. Obviously, there are laws restricting some things, like driving, but the majority of patients follow them and are perfectly good drivers. Hell, they're likely a lot safer than many non-epileptic people behind the wheel.

So what brought on this rant?

Last week the U.S. Supreme Court upheld the Patient Protection and Affordable Care Act (AKA Obamacare). Now this post is NOT about the PPACA. I know a lot of people feel strongly about it in both directions, and if you want to fight about it, go to a website where you can. Because it's not what I'm talking about, or giving an opinion on.

What pissed me off was the reaction of a radio talk show host (who's not a medical doctor).

U.S. Chief Justice John Roberts has epilepsy and (under treatment guidelines) is likely on medication for this (I'm not his doctor). Big deal. So are a lot of other people.

But, as usual, there are some who'd rather smear than respect an opinion. Conservative commentator Michael Savage went on record last week as blaming Roberts' vote on - surprise - his epilepsy treatment (!) saying his writings showed "cognitive dissociation." He noted that drugs used for epilepsy "can introduce mental slowing, forgetfulness, and other cognitive problems."

Yes, Mr. Savage, they can cause these problems. You can also find similar side effects listed for most blood pressure medications, statins, and many other drugs (which, given your age of 70, I suspect you take at least one of) yet I'm not going to say your comments are due to medications. The side effect list of any drug is HUGE. But that doesn't mean everyone who takes it gets them. Quite the opposite.

My point is this: You're certainly entitled to your opinion. But just because you disagree with a man, don't go blaming it on his medications or health. It's a step backwards for all the epilepsy patients out there trying to lead responsible lives in the face of biases like yours. And, I suspect, if he'd ruled the other way you'd never have made such comments.

Since you apparently don't feel people being treated for seizures are capable of making rational decisions or serving in a responsible capacity, I'm leaving you with a list of people who have (or are highly suspected to have had) epilepsy. Perhaps you've heard of some.

Tchaikovsky
James Madison
Napoleon Bonaparte
George Gershwin
Bud Abbott
Julius Caeser
Harriet Tubman
Vincent van Gogh
Neil Young
Lindsey Buckingham
Edward Lear
Prince
Alfred Nobel
Danny Glover
Socrates
Lord Byron
Hugo Weaving
Dostoevsky
Joan of Arc
Florence Griffith Joyner

Last, I should also mention former congressman Tony Coelho, who has the disorder. He was the primary sponsor of the Americans with Disabilities Act (1990). As a young man he wanted to be a priest, but was banned from such by his epilepsy. He also lost his driver's license and health insurance because of the diagnosis.

During his first run for congress (1978, which he won) his opponent tried to paint him with the same insulting brush, asking voters how they'd feel if their representative was at a White House meeting and had a seizure. Mr. Coelho responded, "I knew a lot of people who went to the White House and had fits. At least I’d have an excuse."

Sugar: beats alcohol

Yes, yet another strange news item.


Thank you, Carol!

Random Saturday Pictures

First off, we have this sign spotted at a Burger King. Even ignoring the grammar issues, it has to be the most unenthusiatic, uninviting, unappealing ad for a birthday party I've ever seen.

Just makes you want to yell "Sign me up!" huh?

Next is this fine beverage. Because what could be more enticing than a beer whose name translates to "Sudden Death"?

"Preferred 2-to-1 over Kool-Aid."

My reader Leigh recently got her water bill, and was horrified to find her city is spending tax dollars on a talking toilet mascot named "Leaky Loo McFlapper." They're claiming he's "world famous" (hell, I can't even find a FaceBook page for him) though at least he's not artisanal.

"Someday I hope to work up to McD's, when Grimace retires."

And, lastly, there's this technological breakthrough. Because what good is a $300 phone if you can't use it to open a beer?

Opening a beer? There's an app for that.

Care

I'm with a patient when Mary interrupts me. Dr. Intern is on the phone, and says it's urgent.

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

Dr. Intern: "HI! I just ran a Depakote level on Mrs. Seizure, and it's ZERO! I just spoke to her. She hasn't had any seizures, but I told her she needs to get in to see you ASAP!"

Dr. Grumpy: "Hang on... She isn't on Depakote. I changed her seizure meds in 2010, and she hasn't taken it since then. So I'd expect it to be zero."

Dr. Intern: "Why doesn't anyone tell me these things?"

Dr. Grumpy: "Well, it was noted in the letters I sent you. Don't you read them? Or check a medication list at each visit?"

Dr. Intern: "Who has time for that?"

Gee, thanks

Dr. Grumpy: "What brings you in today, sir?"

Mr. Honest: "Dr. Asshat referred me. He said all the good neurologists couldn't get me in, and so I should see you instead."

Mary's desk

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

Mrs. Bekins: "Hi, I need to make an appointment with the doctor."

Mary: "Okay, what's your insurance?"

Mrs. Bekins: "Um... Gee, I really don't know. I'm in the process of relocating to Grumpyville, and don't have a job yet."

Mary: "All right... Would you like to call back when you know more?"

Mrs. Bekins: "No, I still want to set something up."

Mary: "Okay, when are you moving here?"

Mrs. Bekins: "I don't know yet. Could be anywhere from 3 months to a year."

Pause.

Mary: "I think it would be better if you call back when you know when you'll be here."

Mrs. Bekins: "You're probably right. What part of town are you in?"

Mary: "Do you know the areas of Grumpyville?"

Mrs. Bekins: "No. Can you send me a map? And recommend a realtor?"

Market share

In medicine there's a mysterious villain called "Big Pharma." This is a secret conglomeration of drug companies working to deprive you of both money and health as part of the New World Order. Depending on how far you buy into this bullshit, doctors are a part of this Medical-Pharma complex, along with (depending on your Haldol dose) any religion you hate, the United Nations, space aliens, homosexuals, and the Dead Milkmen.

Now, obviously, I don't believe this. The one grain of truth in the "Big Pharma" idea is that obviously companies that manufacture something want to sell it. This applies to medicines, car manufacturers, potato peelers, whatever.

Drug companies are required to do research to prove safety and efficacy of their stuff. But they also do smaller studies to try and prove they're at least better than a competitor. These studies, I must admit, tend to favor whoever sponsored them- but keep in mind they're trying to knock down competitors- NOT work with them.

A drug company sponsors a study that showed their drug worked. THE NERVE! Because, after all, no other industry would dare act like this...

So let's look at this article.

Basically (for those of you too lazy to click the link), it's a study that found "stone fruits" (those with large, singular, pits, like peaches) help with obesity and diabetes.

Some out there will claim this shows that Big Pharma is keeping "natural" secrets from them (because you'll otherwise NEVER hear that fruits & vegetables are better for you than a Big Mac). But let's read the disclaimer at the bottom of the article:

"The studies on the health benefits of stone fruit are funded by the California Tree Fruit Agreement, The California Plum Board, the California Grape and Tree Fruit League and the Texas Department of Agriculture."

Here's the bottom line: Everyone will pay for research to sell you their product. Whether it's Big Pharma or Big Farm.


Thank you, SMOD!

That's Amoré!

Mr. Fatherly: "It was really stressful 3 months ago, because my son and his fiancée moved in with me."

Dr. Grumpy: "How are things now?"

Mr. Fatherly: "Better, my son finally moved out last week."

Dr. Grumpy: "What about his fiancée?"

Mr. Fatherly: "I married her. That's why he moved out."

Wanted: Students with partial amputations

Somehow I think this could have been worded better:

Thank you, Maridyth!

OH, FOR HELL'S SAKE!!!

 

Thank you, WH!

Notes

Mrs. Flight: "I need a note, saying I'm too sick to travel to New York."

Dr. Grumpy: "Um... but you're not sick at all."

Mrs. Flight: "I know, but I'm trying to get out of this trip, and a note would help."

Dr. Grumpy: "I can't falsify a note for an airline."

Mrs. Flight: "No. It's for my sister. I don't want to go see her because she's a bitch."

Airborn drug transference

Dr. Grumpy: "I'm going to start you on Coumadin."

Mr. Wisconsin: "But I'm already on it!"

Dr. Grumpy: "You are? I didn't see that in your chart..."

Mr. Wisconsin: "Well, I mean, I'm not on it myself, but my wife takes it. So wouldn't that cover me, too? Just from being near her a lot?"

WTF?

I've shown you guys some seriously strange drug company ads over the years.

After 15 years of reading journals I thought I'd seen every weird eye-catching trick an advertising agent can think up.

But, even I was taken aback by the sheer WTFness of a veterinary drug ad my esteemed colleague Webhill sent me yesterday:

 

 Thank you, Webhill!

Decimal fetish

Dr. Grumpy: "Any changes in your weight?"

Mr. Precise: "Yes." whips out iPhone "As of this morning, since January 1, 2012, I've gained 1.5873 pounds."

Saturday night, 11:38 p.m.

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

Miss Hedayk: "Yeah, I see you for migraines, that I, uh, only get during sex..."

Dr. Grumpy: "Yes?"

Miss Hedayk: "Well, I'm over at the Meat Hook bar, and met this really hot guy, and I'm um, out of my migraine pills, and, uh, could you call some into the pharmacy, so I can pick them up on the way to his place?"

Happy Father's Day, Dad!

Language

Dr. Grumpy: "It looks like you have high blood pressure?"

Mr. Semantics: "I wouldn't characterize it as such."

Dr. Grumpy: "Okay, but you're on 3 blood pressure medications."

Mr. Semantics: "My internist and I have a difference of opinion of both vital signs and common vernacular."

June 15, 1944

Officer Cynical asked to do a guest post today, in memory of those who gave all in one of the most vicious battles of World War II. Take it away, Officer!

On June 6, 1944 the largest amphibious invasion in history took place in Normandy. Lost in its shadow are equally important events that happened at the same time on the other side of the world.

Today, June 15, 2012, marks the 68^th anniversary of the U.S. Marine assault on Saipan.

On June 5, 1944, the same day the allied invasion ships set off across the English Channel for Normandy, another amphibious force left Pearl Harbor to carry out a mission of equal importance in the Pacific. It's almost-forgotten today, but the effects were tremendous. As one Japanese admiral commented, ""Our war was lost with the loss of Saipan."

Saipan was an important objective, both to cut off Japanese supply lines and to provide an airbase from which bombers could reach the Japanese home islands.

At 8:00 a.m., 8,000 Marines came ashore against 31,000 Japanese defenders. Many Marines later stated it was the most savagely opposed amphibious landing of the Pacific war.

Japanese artillery (pre-aimed at the invasion beach), along with machine-gun and sniper fire, made the landing murderous. You can see in the photos below the desperation of the men who have just hit the beach.

Men & machinery coming ashore.

Crawling to duck snipers

The Marines at the center and far left have just been hit by enemy fire.

Many enemy artillary positions were neutralized by gunfire from American warships, which was guided by Navajo code-talkers who'd gone ashore with the troops.

The morning after the landing, the Marines awoke to find every support vessel except a hospital ship had left. The Japanese Imperial Navy had counterattacked the U.S. Task Force near Saipan in an attempt to reinforce and resupply the defenders. The result was the naval/air Battle of the Philippine Sea, and the decisive allied air victory called The Great Marianas Turkey Shoot.

Ultimately, the combined American forces of Marine and Army units numbered about 70,000 men. After three weeks, the Japanese staged a last-ditch banzai charge of about 4,000 soldiers, including their wounded and conscripted civilians. Some had no firearms, but carried sticks with knives tied to the ends and other crude weapons.

Shaking out a shoe, sitting on an unexploded shell from a battleship.

 In the end, 13,790 American (19%) were killed or wounded. 29,000 Japanese (94%) were killed; only 920 prisoners were taken. Some 20,000 of the 25,000 civilians living on Saipan also died, almost all by suicide, either by jumping from cliffs (after throwing their children off) or by blowing themselves up with grenades. They had been convinced by the Japanese military that suicide was preferable to capture by the Americans. 

The nightmare of Saipan shows on the face of this Marine:

The "thousand-yard-stare"

Hospital rounds

Dr. Grumpy: "What color is my shirt?"

Ms. Haldol: "As black as your greedy, money-grubbing soul you bastard!"

Turn in your man card, dude

Sheesh, wouldn't it be better to just lie?

Patient quote of the day

"I have a huge pituitary tumor. They told me it was pressing on my sciatic nerve."

What SHOULD she do?

Sermo is an online doctor community. Once or twice a week I skim the posts to see if there's anything of interest.

Anyway, one hazard of technology is that a lot of people post while typing on the fly. This, combined with autocorrect, can lead to some eye-catching items.

ADDENDUM: due to lawyers from Sermo sending me threatening email, I had to take the screenshot down (those of you up early saw it). Basically, what it said is:


"One of my colleagues recently had a tubal legation. Now her vagina is demanding an embassy. What should she do?"

Great office moments

Mr. Ataxic: "I've been having a lot of balance problems. My walking is off, and I'm clumsy."

Dr. Grumpy: "Let's go out in the hallway, and let me watch you walk."

Mr. Ataxic goes out in the hallway, and I follow him. Stepping out from behind my desk, I discover (too late) that my shoelace is caught in one of the chair's rollers. As I walk the chair comes with me. I lose my balance and fall, just barely missing Ed. Then the whole chair crashes down on top of me. As the chair flies up it pulls my shoe off and sends it flying under the desk.

Mr. Ataxic: "Yeah, doc, kind of like that, but not as spectacular. Holy shit, are you okay?"

Weekend reruns

Okay, Grumpyites. My friendly neighborhood Lidoderm (a skin patch for pain after shingles) drug rep left me this.

Drug reps aren't allowed to take us to ball games anymore (I'm okay with that). In fact, this year they've actually been banned from bringing us even cheap pens and post-it notes.

BUT they are still allowed to bring us oddball stuff which falls under "patient education". Like this thing:




What is it? An art deco cactus garden? A model of Bikini Bottom (the home of Spongebob Squarepants)?


Nope. It's a model of the nerve endings of your skin, showing how painful post-shingles pain can be. When you turn it on, notice how the nerves glow red (it's pain, get it)?





And HERE! When you push down on the Lidoderm patch (get it? you're applying it to the skin?) they now glow soothingly blue (ah, that feels better). Thank you, Craig, for the hand cameo.



Isn't this useful! Isn't this revolutionary! Isn't this a great use of your medication money!

The kids and I have now taken out the batteries, and this weekend will study the feasibility of turning it into a new home for Ed, my office fish.

America. Land of really strange crimes.

Some days you think you've seen it all. And then you find out you're wrong.

Thank you, Mark!

Patient quote of the day

"I was on extreme doses of extremely powerful pain medications, because my symptoms were, you know, extreme. My doctor was extremely worried that I'd get extreme side effects, but apparently I have extremely high tolerance. They told me my liver is extremely strong."

Wednesday afternoon whatever

Mr. Webster: "My mother died of coronary trombones."

Dr. Grumpy: "You mean thrombosis?"

Mr. Webster: "Whatever."

A-Z

GOALLLLLLLLLLLLLLLLL!!!!!!!!!!!!!!!!!!!!!!!!

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

Ms. Fifa: "I need to make an appointment with Dr. Grumpy right away! When I exercise I get these horrible headaches! They just started last week, and I can't do anything!"

Mary: "Okay, we can see you Thursday afternoon..."

Ms. Fifa: "Oh, I can't come in then. That's when I play soccer."

I have a bad feeling about this

Dr. Grumpy: "What medications are you on?"

Mr. Scattered: "I don't know. Whatever my girlfriend puts in my pill cup."

Dr. Grumpy (to girlfriend): "What pills does he get?"

Ms. Girlfriend: "I don't know the names. Whatever his mother tells me to give him."

Dr. Grumpy: "Where can I reach your mom?"

Mr. Scattered: "She's in jail."