Then why ask me?

Mr. Tophi: "Look at this thing on my foot. It really hurts. Is this from my Parkinson's disease?"

Dr. Grumpy: "No, that looks like gout."

Mr. Tophi: "Funny, that's exactly what my podiatrist and internist said, too."

Does she live near a nuclear plant?

Reading notes from another doctor yesterday I discovered this line:

"The pain radiates from her neck into the right shoulder, then down the dorsal aspect of the arm and hand into the 7th & 8th fingers."

Skool nerse time

This is Mrs. Grumpy.

Dear Parents,

I encountered quite a few of you last month, as I got suckered into doing the summer vision and hearing screenings at Douglas C. Kenney Elementary School.

This is basically a volunteer job for the nurse involved. The district pays us (literally) minimum wage to be there. The tests are done routinely during the school year, but, trying to be accommodating, they offer them in July, too. So a teenager flipping burgers over the summer is making the same as the nurse checking his vision. I'm not telling you this for sympathy, but rather to make you understand that I'M NOT DOING THIS FOR THE MONEY. I do it because I care about your kids, and (more importantly) because it gives me a few hours away from mine.

Bringing your child in to get his hearing tested is a good thing. Bringing in his 18 siblings, or even just one screaming infant, defeats the entire process. To accurately test Junior it needs to be QUIET.

Since you apparently don't know what that means, here it is: no other kids playing loud video games, an infant screaming because you haven't changed her diaper in 2 weeks, talking loudly on a cell phone about which movie to see with friends later, eating a bag of extra-crunchy Cheetos, or all of the above. Also, you don't need to change the baby in my small office. There's a bathroom across the hall, and we are not testing your kid's sense of smell. Or mine.

Don't tell me it's okay to do any of these things because the front desk girl told you so. She's the chewing-gum-popping daughter of the woman who works there during the school year, and is too busy texting her friends to pay attention to what you're asking. She's not saying yes, just nodding her head in time to whatever song is playing. 

If you can't sit in here and be quiet, then go out to the fucking lobby and leave me and your kid in here. I'm not going to molest them. You can check my license online. I've never been in jail, gotten anything worse than a traffic ticket, or coached at Penn State. If this option absolutely, positively doesn't work for you, then GTFO and have your precious child tested during the regular year like everyone else.

Next is the vision issue.

I understand you feel Junior looks cool, cute, or whatever while wearing sunglasses. But he needs to take them off to do vision screening. We are not outside in direct sunlight, and hopefully he isn't in the Witness Protection Program. We are inside, under generic fluorescent bulbs. Wearing sunglasses may work for the top 2 Snellen lines, but not when they get toward the bottom.

Also, I'm sorry the eye chart isn't the one your kid fucking memorized from Wikipedia so she wouldn't have to get glasses. We know these games. As hard as it may be to believe, we school nurses were once kids. And most of us have our own, too.

Finally, I am NOT, in any way, shape, or form, responsible for your child being blind or deaf, or you being stupid. The school district is doing this testing free of charge. They are NOT giving out vouchers for eyeglasses, hearing aids, or doctor visits. If your kid failed the hearing test because you just had to bring his twin siblings and their Game Boys, and now you have to pay to go see a real audiologist, THAT'S NOT MY FAULT.

Don't give me bullshit like "the last nurse passed him," "you didn't set the machine right" or "his sister didn't have a problem." I DON'T CARE. Contrary to popular belief, I do not have some sort of personal vendetta against your child (you, maybe, but I won't hold that against him).

Also, telling me that any problem the test found is my fault doesn't fly. You'd think I'd be shocked that so many of you feel I should personally pay for new glasses/hearing aids because "he didn't have a problem before you did the test," but sadly I'm not surprised at all. And no, I'm not paying for them.

Have a nice day.

Summer vacation

At my family's request, I am ending the current Summer vacation series. I will return to regular blogging on August 20, 2012.

Grumpy Summer vacation, day 3

Today my aunt drove us to pick up our rental car. We'd decided to leave the legendary Grumpy Family Truckster at home and rent a car. We loaded it up, and off we went to Las Vegas. Since the kids had so much fun there last year, we wanted to go back.

Approaching Vegas, we passed one of it's most famous celebrities.

"Don't run over my blue suede shoes."

We decided to stay at the Flamingo this time, as the staff we'd spoken to last month had told us about all the great pool features, including it's huge size, and the waterfall they can swim through. Unfortunately, we discovered they hadn't been entirely truthful. Yes, they do have a humungous pool with a big waterfall. Unfortunately, kids aren't allowed in it.

Families with kids are limited to 2 small pools. One is surrounded by fountain statues of Flamingos spitting into the pool (I SWEAR!) and the other is even smaller and has a water slide and dinky waterfall. Both were packed wall-to-wall with people, and not nearly enough chairs available. So I sat on a concrete wall while the kids swam, and pounced on the first chair I saw open up (okay, so I waited until this old lady's family wasn't looking, then I pushed her off a chair, threw her glasses in the trash, and grabbed her marble rye). My kids were similarly unimpressed with the pool, and kept asking if we could go to another hotel.

As I tried to relax and play Russian solitaire on the iPad (sorry, Klondike fans, I learned this one from my grandfather, and it's my game of choice) a couple next to me were playing dominoes while their kids swam. At some point this innocuous tile game became a proxy between them to fight over who's fault a recent speeding ticket was, why the kids wear out shoes so fast, when can they afford to go to Hawaii, and (finally), who's turn is it anyway. At that point the game ended when she turned the board over and sent tiles flying everywhere.

Another issue was that while families weren't allowed in the big adult pool, childless couples were allowed in the kiddie one. So a pair of newlyweds came over to try out the waterslide, then decided to stay. Since pool chairs were at a premium, they shared one. Being newlyweds, this proximity resorted in them starting to make out, then using strategically placed towels to go further. After they finished I wasn't sure if I should applaud or not.

One thing that I find incredibly annoying about Las Vegas is that all the pools close at insanely early hours, usually 5:00 for kid pools, 7:00 for adults. I don't understand this at all, especially in Summer when it's daylight until at least 8:00 p.m. Hotels everywhere else keep pools open till at least 9:00, and often 10:00 or 11:00. Except in Vegas.

While walking to dinner we engaged in the popular Vegas sport of avoiding guys handing out cards with hooker's phone numbers (except for Frank, who tried to get the ones with pictures on them. Craig wanted to, but doesn't have Franks lack of inhibition). During this time the kids kept bumping into each other, until finally a fight broke out over who stepped on who. Of course, this sort of thing always seems to happen when you're dodging cars/hookers/hobos/Elvis, making the situation as chaotic as possible. After we got them separated Mrs. Grumpy pointed out a remarkably appropriate sign nearby:

Sums up traveling with kids, huh?

 

For dinner we went to the Planet Hollywood buffet, which is done up with movie posters. This one caught my eye:

Somehow, I just don't see a movie today being marketed with that tagline.


Afterwards we walked over to the Cosmopolitan hotel. (MOM! ARE YOU READING THIS? GOOD!). We did this because my parents were in Vegas a month ago, and Mom made a big deal about how neat the Cosmo's lobby is. She (YES, MOM, YOU!) told us we should take the kids there because they have these really cool columns with TV screens that show changing pictures, and that the kids would love them. So we went.

Well, I guess they changed the pictures since then (or my mom needs new glasses) because when we got there the lobby columns were showing a silent movie of a silhouetted, but obviously nude, woman. And she was doing some sort of semi-erotic dance with a large dog. I am not making this up.

When I called my mom tonight to tell her this, she said "well, I only told you they were interesting." Great, ma. I'll have Marie call you when I find her dancing naked with Snowball in the bathroom.

Grumpy Summer vacation, day 2

This morning I noticed that I only had one day of deodorant left, and so we stopped at Target. Thanks to the miracle of GPS, it's possible to find pretty much anything, anywhere, provided they haven't started doing extensive road construction since the last time your GPS unit was updated. Which, of course, they had. So we drove my cousin's borrowed truck in circles for an hour trying to buy one stupid deodorant stick.

Today we went over to a cousin's house. The original plan was for the kids to spend the day out in their yard, which has all kinds of stuff. Unfortunately, some local inhabitants had other plans.

Damnit, Jim, I'm a doctor, not an apiarist.

So we went to an aquarium instead, where we got to see the bravest man in California cleaning a tank:

Yes, folks, the fish really were in there, all cowering in the left corner. So much for using them as watch fish in my swimming pool.


And then, because the cousins outvoted us, we ended up going back to (drumroll, please) Lego Land! Did I mention that I can't wait till these passes expire next week?

Lego Land, like every amusement park on Earth, has a generic "Wild Mouse" type roller coaster. Here it's called "Technic." It's not bad, but while waiting in line you're subjected to this horrible synthetic-industrial-pop soundtrack that plays the same 30-second sequence over and over AND OVER again. Until you want to move like Shields & Yarnell (yes, I'm old). How the people who work on the ride put it up with it all day I don't know, but you'd think one of them would snap sooner or later and add "going Technic" to the American lexicon.

Lego Land sells these little plastic packets, each with some sort of collectible minifigure in it, and they change minifigure sets (16 in each! Collect them all!) every 3 months. And once they're gone, THEY'RE GONE. Never to be released again in any form.

This is what they look like.

Now, I personally don't give a shit. I mean, they're freakin' Legos! And each minifigure is $2.99 ($3.22 with tax- you learn that fast). But my kids saved up a crapload of money just to buy them here (Grumpyville has 3 Lego stores, but that's not good enough for them). Of course, each kid has a specific request: Craig wants Little Red Riding Hood, Marie wants King Neptune, and Frank wants Astronaut Soldier That Looks Kind Of Like The "Halo" Guy.

Of course, they don't actually SELL the damn things labeled, so you can see what they are. They're in giant bins in every Lego store (and there's one every 50 feet here), sealed in identical plastic wrappers. You have no clue which one is which. So your kids (and everyone elses) stand around fondling packages, trying to figure it out. "Dad, does this thing in the bottom corner feel like Neptune's trident/a picnic basket/a space rifle?" And, of course, I have no idea. It feels like a hard piece of molded plastic, okay?

You'd think they'd put a label on them, to help kids. But the store dude told me that's not allowed, because it brings down the value for collectors. Yes, collectors. People who will pay big money in a few years for a sealed plastic packet, that for all they know has a broken figure and a rat turd in it. Because what's the point of blowing 2 months worth of salary on a small plastic toy if you actually know what it is?

So, each Lego store usually has one employee with a good sense of touch who can feel around and tell you what they are, sometimes. Not always. You have a 1 in 16 chance of being right.

THEN there's the guy at The Big Store, which is the main sales place at the park entrance.

I don't remember his name. Something like Ricardo. He reminds me of Franck Eggelhoffer, the insane wedding planner (played by Martin Short) in "Father of the Bride (1991). Complete with the nonspecific accent and flamboyant mannerisms.

But damn, this guy is good. No matter what they pay him, it isn't enough. He sells his weight in minifigures every 10 minutes. He should have his own TV show.

Kids find him and ask for, say, the Easter Bunny figure, and he takes it from there.

"The Easter Bunny, yes? You want Ricardo to find an Easter Bunny for you?" And with great theatrics he walks over to the bin, runs his fingers over 200 packets in 10 seconds (he doesn't look at them- sometimes he closes his eyes for effect) and then whips one out, snaps his fingers, announces "Ricardo has found the Easter Bunny!" and tosses it to the kid. Then it's the next kid's turn. This guy has some sort of zen-Lego magic touch. Even the other employees are in awe of him.

The best part is when some kid questions him "Are you sure this is the Easter Bunny?" Ricardo claps his hands and indignantly exclaims "Ricardo is NEVER wrong!" and goes back to his next request. And, I must admit, on this and several past trips  (he draws a crowd, he's that good) I've never seen him screw up yet.

Then the real insanity begins.

Every Lego Land employee has one or more of these coveted minifigures on their name badge, and kids can trade if they see one they want. So my kids will bring some from home to do this. Marie loves to buy them in the store, pocket the accessories, and then trade the naked figure for a fully equipped one, pull off their aceessories, and repeat (warning: this doesn't always work, depending on the employee). I've actually seen roller coaster rides delayed because kids are trading figures with the guy who works the controls.

Where this makes you want to pull your hair out is when your kid just spent 30 minutes looking for a certain figure, finally gets Ricardo to find it for them, is overjoyed to have bought it, and one minute later trades the damn thing to a guy selling churros outside the store. This happens all the freakin' time, and makes me glad I brought my Rogaine.

At one point, in an exchange that had me in hysterics, I watched as Frank traded figures among 3 park employees and 4 other kids who were walking around Pirate Shores, and at the end of 10 minutes he discovered he had his original figure back, with absolutely no new accessories.

I don't understand it either.

But you know what has REALLY pissed me off on this trip? It's going to sound stupid (because it is).

They used to have this great attraction where families would race firetrucks against other families. Four families would compete in a vicious, no-holds-barred competition to pump giant Lego fire trucks across a track, aim 2 water cannons to put out a fake fire, and then pump the trucks back. You play for pride (not even a cheapshit $2.99 Lego figure, FFS) but for 10 seconds afterward the victors can bask in the glow of having won.

Hell on wheels. With kids.

Not anymore.

Now, for reasons which the staff will only explain as "an accident happened," YOU CAN'T RACE. You all try to pump the cars slowly across the track, getting to the fire at the same time (waiting for the other trucks to arrive) then put out the fires, get back in the trucks (waiting for the idiots who can't figure out how to work a toy water cannon to finish) and then go slowly back to the finish together.

WHAT THE HELL IS THE POINT OF THAT?!!! If you're going to do some manual labor at Lego Land, it should be to prove you're better at it than other families!

Obviously, it's really pathetic that this pisses me off as much as it does, and likely takes the phrase "first world problem" to a new level.

I'm going to bed now. King Neptune, Astronaut Soldier Guy, and Little Red Riding Hood are looking like they want to start a threesome, and I'm keeping them from getting it on.

Grumpy Summer vacation, day 1

This year we decided to start the trip by flying to San Diego, to visit my family there.

The flight from Grumpyville to San Diego yesterday was going fine, until the flight attendant brought Craig a little packet of artisanal hypoallergenic goldfish crackers. She complimented him on his hair, and he quickly become even more insufferable about it (hell, I didn't think that was possible).

Today we (and some cousins) went to Lego Land. This will, mercifully, be our last trip there because my kids are getting pretty damn old for it (they insisted on going! Not us!) and our annual passes expire next week. So this gives me a good reason to be done with the place. I have nothing against LL, but it gets old after a while. There's a reason you don't hear Super Bowl winners yell "I'm going to Lego Land!"

I suspect most of their "Master Builders" (that's what they call them, I swear) are working at the new Florida park, as the California one could use some upkeep. One of the big construction dinosaurs ("Lazy Pete") you see near the entrance is pretty well covered with black gunk. You get a frighteningly good look at it on the Coastal Cruise ride.

This a boat ride that takes you around various (fairly impressive) Lego structures of world monuments such as the Eiffel Tower, Sydney Opera House, Taj Mahal, etc. But the ravages of nature affect the Lego models just as much as the real ones, but on a more dramatic scale. Today the Lego man cleaning the windows on the Opera House was partially trapped in a spider web, and there were gigantic (by comparison) pigeons perched on the Eiffel Tower. With, I assume, huge bird droppings threatening to crush cars and pedestrians below.

From a perspective view these would make great horror flicks.

The annoying thing about Coastal Cruise is the guide's patter, which never changes. "Make sure you have your seatbelts on!" (riders look for seatbelts) "Just joking, there aren't any!" or (in a part where a Lego figure looks like he's about to fall on the boat) "Don't worry folks, he's been hanging on there for 14 years, and he hasn't LEGO yet!" They also always add something like "He's made out of 1,324,863 Lego bricks and took 346.57 hours to put together."

This is minor league stuff of course. Let's face it: the ride by which ALL corny boat ride monologues are measured is the Jungle Cruise at Disneyland. As far as I can tell (as of my 2008 visit) the patter there hasn't changed since I was kid. I guess this is part of the attraction. ("You're lucky your guide is such a crackpot!"

The cultural impact of the Jungle Cruise (most famous line is about hippos wiggling their ears) is such that it was further immortalized by Weird Al Yankovich in his song "Skipper Dan."





So, I think the bottom line here is that when you're working on the Coastal Cruise, you're in the minor leagues, and hoping to be called up to the majors in Adventureland.



The models also need to be repaired. Take this Lego butterfly that's up on a pole:

It looks good. I mean, pretty impressive when you realize it's all made out of Lego's. But on the next pole over:

The butterfly on the right has lost a chunk of one wing (likely fallen, shattered, and pieces picked up by passing kids as free Legos). The one on the left has lost pretty much everything, and what remains looks like one of Gene Simmons' evil robots from the 1983 movie "Runaway."

Over in Miniland we witnessed a traffic accident:

I hope all the Lego people are okay, and that the school bus driver has good insurance.

Frank, for whatever reason, has named his winkie "Bob." As we passed the theater showing "Bob the Builder in 4D" They have an overhead recording that says "Come on in and join us! Because no one can get enough of Bob!" The 5 of us broke into hysterics, leading many to assume we were nuts. Which we probably are.

They've installed a new water ride since we were last here, which was originally used for interrogation at Guantanamo Bay. It's called "Pirate Reef" and consists of a boat-flume type ride, with a single drop. Craig, who LOVES soaker rides, conned me into trying it with him.

It looks deceptively harmless. You figure, "Okay, maybe I'll get a little wet." Sucker.

You first realize something is amiss when they make you put EVERYTHING attached to you into a plastic bin before boarding: watches, glasses, phones, toupees, cameras, jockstraps, facial moles. Then off you go, in a boat that holds maybe 15-20 people. After getting in you realize that the bottom of the boat has 3-5 inches of water in it, and your feet are soaked. This is your first warning.

You chug around the little loop peacefully, then start the slow climb to the top. You are trapped.

And then you have the drop.

As you hit the bottom there's a split second where the water splashes up, you get a little wet, and you think "that's not so bad."

Then you get walloped. Because of the landing basin's design the entire water displacement of the boat and people in it is projected directly UP OVER YOU. So while you're thinking "this isn't so bad" the mass of water is right above your head, and starting to come down.

On impact it takes you completely by surprise. The practical effect is that you're completely underwater for 1-2 seconds, and get SOAKED. There is nowhere to hide. The entire boat gets it equally.

And it isn't over. As you come out of the downpour you go between 2 large Lego pirate ships. With 10 water cannons on each side, shooting down at you. Manned by the last people who went through the ride, and now looking to take it out on the next group of riders. They can also shoot at each other, but prefer to hit you. After you pass this there's a few more H2O sprayers to get through before returning to the dock. Where they cheerfully return your goods to you, as you drip all over.

Of course, you're now soaked, and so decide to stop in the pirate ships yourself to spray the next group of suckers. Craig and I got on different pirate ships, and battled each other.

Then the next boat came down. And in our determination to soak its payload we suddenly realized that the tsunami wave it generates would soak us again, 20 feet up on the pirate ships. DRENCH!

As we walked away from this aquatic conflagration I realized that, in spite of both of us being completely soaked to the skin with our shoes filled with water, Craig's hair was miraculously dry, perfect, and radiant.

Grumpy Summer vacation, 2012

Since I'm spending the morning frantically looking for plane tickets, my sunglasses, and kids, a special guest blogger has kindly offered to make the traditional announcement for me:





Thank you, Ambassador!

Vote Grumpy, 2012!

As the 2012 Presidential campaign goes on, I think it's time that I introduce more of my platform.

Certain phrases will be retired, or have strict limitations on them:

The words "artisan" and "artisanal" can only be used to refer to products manufactured by a company with fewer than 20 employees, and cannot be used for anything naturally grown (like lettuce, FFS). If it's not handmade, it's not artisan.

The use of the phrase "reaching out" and its derivatives will be punishable by death. I am sick of hearing "I'm reaching out to you today" or "We're trying to reach out." Bullshit. Do you say "I reached out to Mom to wish her a happy birthday?" No! You freakin' called her. Or sent her a card. Or email. Or whatever. "Reaching out" is what you do when trying to get pancake mix off the top shelf.

"Reaching out's" evil twin "touch base" will also be banned. Not only is it stupid, it sounds like a code phrase Jerry Sandusky would use. It will be strictly limited only to baseball announcers where appropriate.

Saying "think outside the box" will be punishable by being interred in a large box. Without airholes.

"Empower" really needs to go. It's stupid. I mean, hell, I empower my kids to take out the garbage, and they still don't. It's condescending. Worst of all, it brings back memories of a horrific blind date I went on in the early 90's where this girl kept saying it. She empowered me to pick a restaurant. She empowered me to order for her. She empowered me to decide what show to go to, and where to have a drink after the show. And after all that she didn't even empower me to sleep with her.

Want to use the phrase "push the envelope"? Under President Grumpy you'll be sealed in a big paper envelope and pushed into the Grand Canyon.

Do you always "give 110%"? Good. Because pretty much all it says is that you're a moron who failed 3rd grade math. If you're caught saying it when I'm in office you'll be sent back to grade school. And have to sit in one of those tiny desks.

The Disney company will be forbidden to use the word "classic" in advertisements for pretty much anything. And they can't use artisanal, either.

There will be a minimum wait time of 25 years before Hollywood can even think about remaking a movie. Violators will be forced to watch the new "Total Recall" until they gouge their eyes out.

The phrase "goes" to refer to people speaking will be replaced by the rightful "says." Believe it or not, this one drives me crazier than any of the above. It started when I was in High School, and just keeps spreading. Like Ebola.

Politicians who espouse screaming and yelling at the opposition will be dropped into a desert with an equal number of equally stubborn people from the other side, under circumstances where their mutual survival depends on finding ways to work together and be polite. This will be aired as a TV show called "Modern Sandbox," with advertising revenue and T-shirt sales going toward the national debt.

Remember: Vote Grumpy in November! Unlike my competitors I actually have my birth certificate immediately available (sort of - I think it's in an old briefcase in the back of my Dad's closet) and I don't own an Olympic horse that I'm spending $77,000 per year on. I've also never driven with a dog strapped to the roof of my car. And I've never been to Kenya. Or Africa. Or the moon. After all, these are the REALLY important issues you should be paying attention to, not silly things like the economy or women's rights. And, like any good politician, I'm for sale. Someone (hell, anyone), please buy me. I take Paypal.

OH NO! That will never come out of my shirt!

Yes, worse than getting blood or grease stains on your clothes:

Thank you, Webhill!

Fashion

They turned off the air conditioning at my office last night for repairs, so when I got here early this morning it was quite warm. Since on Fridays no one else comes in until 9:00, I took off my shirt.

I went up front to get water from the cooler, and found myself at the front window, face-to-face with the lung doctor next door. He'd just gotten out of the elevator across from my door.

The bottom half of the front window is fogged. So for all he knows...

This can only improve my reputation.

Effort

Today I'd like to share this bracelet, which was sent in by Beth (thank you, Beth!). Her husband got it after being treated at an outpatient surgicenter:

Now, I don't know about you guys, but I don't find this particularly reassuring. Granted, the word "excellent" is pretty overused these days, but still. They might as well write "Our goal is anything above mediocre care" or "Our goal is to avoid being on Fail Blog." I mean, this is surgery for crap's sake. I don't think "very good," even when all capitalized, sounds especially comforting.

I could probably go on with a whole post about how many resources are wasted on these stupid bracelets, which my kids bring home from school for one cause or another almost every freakin' day. With various shit like "I believe in art class" or "Support your local pencil factory" or "Eat at Rigatoni's House of Overpriced Pasta." They end up all over the floor, and then get tossed in recycling. But I think I'll stop there.

Life at the cheap motel

Dr. Grumpy: "Okay, we'll try this new medication, and I'll see you back in a month. Any other questions?"

Ms. Viridae: "Yeah, it looks like I have, um genital herpes. Can you call in some Valtrex for me?"

Dr. Grumpy: "No, that's not something I treat. I recommend you go back to your family doctor to have it properly evaluated and get the right medication."

Ms. Viridae: "I'd rather not... I think he's the one who gave it to me."

Tuesday morning, 2:18 a.m.

"Hi, can someone call me back? I saw you in 2005, but changed to another doc because I didn't like you. Anyway, that doc just moved away, and I'm out of Vicoden. Can you please call some in for me until I can find another neurologist?"

Tonight's health tip

While I don't have any large-scale, double-blinded, placebo-controlled studies to back it up, I'm going to go out on a limb with this recommendation:

IT IS NOT, UNDER ANY CIRCUMSTANCES, A GOOD IDEA TO SHOVE LIT FIREWORKS IN YOUR ASS.

This has been a public service announcement from Grumpy Neurology, Inc.

Today's quiz

This picture:

A: Shows why you shouldn't pass out drunk when your friends have magic markers lying around.

B. "OMG grandma, I told you not to use the discount tattoo place!"

C. Is the latest innovation from Apple, the iBrain. The flash drive is planted right under your skin, and connects in your gums via Bluetooth.

D. Is from an ad for a new type of brain scan.


The correct answer is D. Really!

Weekend reruns

Dear Dr. Worthless,

Thank you for your note on my migraine patient.

I've tried several medications for Mrs. Hedhurtz, including Fukitol, Painbegone, Nomigraine, Acefalgia, Gonehert, and Nopayn, all without success.

I've done MRI's, MRA's, and a spinal tap on her. I sent her to an ophthalmologist.

I was frustrated. She was more frustrated. I wasn't having a lot of success helping her. And she seems like a nice lady.

So, since you advertise yourself as a neurologist who specializes in treating difficult headaches, and cite your 2 years of headache subspecialty fellowship training, I decided to refer her to you. You opened up shop near me last month, so I thought I'd give you a chance to earn my referral business. Your marketing person dropped off some cards here 2 weeks ago.

And yesterday I got your faxed note about her.

At the beginning of your note it says that "I've reviewed Dr. Grumpee's notes and tests in detail." That was your second lie (your first lie is in calling yourself a headache specialist, or even a doctor). I also loved the fact that you spelled my name wrong.

Your note ends with the following, which I've paraphrased.

"Impression: Mrs. Hedhurtz suffers from chronic headaches. She's previously failed trials of Fukitol, Painbegone, Nomigraine, Acefalgia, Gonehert, and Nopayn. I suggest she be referred to an ophthalmologist. A spinal tap should also be considered.

For future treatment, I suggest she be started on a medication that she hasn't previously tried before. I've referred her back to Dr. Grumpee's care to follow my recommendations.

Yours truly,

I. M. Worthless, M.D."


Thank you SO much for your helpful advice. I'd normally say "thanks for nothing", but what you've done doesn't even amount to that much.

As my late grandfather would have said, "this is the second time I've sent you a patient. First and last."

Sincerely,

Ibee Grumpy, M.D.

July 28, 1909

The Waratah wasn't a fancy ship compared to the giants that crossed the North Atlantic. She was built for mixed-use (both freight and passengers) but still had fashionable features to keep her travelers comfortable. She worked the long (6-8 week) voyage between England and Australia, serving stops in South Africa along the way.

And 103 years ago today she disappeared. Without a trace.

211 people vanished with her. She'd stopped in Durban, South Africa, where one passenger disembarked as he felt she was top-heavy and unsafe. She left port later that day, never to return.

Cruising along the South African coast on July 27, 1909 she was passed by (possibly) 3 other ships, though identification was difficult. The Waratah, like many other ships of the era, didn't carry the newly invented telegraph equipment.

The area is known for monstrous freak waves, which can overwhelm and badly damage ships. One steamer reported seeing a ship coming up quickly, possibly on fire (though it could also have been a brush fire on land, which were common). A police officer patrolling the Transkei coast thought he saw a large ship offshore being battered in huge waves, finally rolling over and sinking.

She was expected to reach Cape Town on July 29, but never made it.

The Royal Navy quickly launched a search with 3 cruisers, without success. One of them (HMS Hermes) was so badly damaged by huge waves that she required extensive drydock repairs upon return.

Further patrols were sent out, both private and government sponsored. All together they covered 14,000 square miles of water of South Africa. Without any evidence of the Waratah.

Not a single verifiable trace has ever been found. A few sightings of what may have been bodies floating off the coast afterwards, or a non-identifiable chair cushion bobbing on the waves. All seen from passing ships, but no one stopped to get a better look. For all we know they were seaweed or aquatic objects.

Leads have come in sporadically over the years. In 1925 the pilot of a plane reported seeing a large vessel on the bottom, but searches of the area have since been unsuccessful. Similar searches of the offshore area where the officer reported seeing a ship sink have also found nothing.

Twice it was thought her wreck had been found, but on investigation they turned out to be other lost ships. One was a freighter sunk during World War II.

What could have happened?

The answer remains a mystery. She was considered a safe, well-built ship, and had received top ratings from government inspectors and insurance companies.

A great deal of investigation time was spent on descriptions of her stability, but in the end a board of inquiry was unable to find any clear evidence of her being unseaworthy.

103 years later and we're no closer to finding her, or learning the fate of 211 voyagers, than we were in 1909. Like U.S.S. Cyclops, this is a mystery I'd love to see solved.

But I'm not optimistic.

Patient quote of the day

Mrs. Young: "I like to walk a lot, but not hike. I prefer streets. I like to streetwalk. Um, that didn't sound good, did it?"

Magic

Dr. Grumpy: "Have you lost or gained any weight since starting Fukitol?"

Mrs. Pound: "I don't know... I don't have a scale at home."

Dr. Grumpy: "Okay, then let's go over to the scale. I need to know what your weight is on the drug."

Mrs. Pound: "No, you don't need to."

Dr. Grumpy: "I'm sorry, I do."

Mrs. Pound: "No, I'm not going to. A good doctor should be able to tell my weight just by looking at me."

Drug rep swag

Since January 1, 2009 drug reps haven't been able to give us any of their goodies like pens, post-notes, calendars, or pretty much anything.

However, my colleagues in non-human medical fields are exempt. So veterinarians still get their bountiful, yet bizarre gifts. My colleague Webhill recently received this gem, which she kindly sent:

What the hell is that? A rubber cat? A hurkle? (no, wait, it has 4 legs, not 6) A Pokemon?



Nope. It's a flash drive.

Because, let's face it. Nothing could ever make your day like having someone ask, "Hey, doc, why do you have a blue cat's butt sticking out of your computer?"

Do not try this at home. Or anywhere.

Gee, I wonder how much he won?

Thank you, Brick!

Odd numbers

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

Mrs. Trilateral: "My Mom has had breast cancer 3 times, once on each side."

Heroism

My deep sleep is shattered by hysterical screaming of the psychopath-with-a-butcher-knife-has-broken-into-the-house-and-is-about-to-kill-me sort coming from Craig's room.

I go flying down the hall.

Dr. Grumpy: "Craig! Are you okay?!!! What's wrong?!!!"

Craig: "THERE'S A LIZARD ON MY WALL!!!"

Dr. Grumpy: "That? For crap's sake, Craig, it's 2 inches long. They eat bugs. It's not going to hurt you."

Craig: "IT COULD CLIMB UP TO THE CEILING AND GET OVER MY BED AND DROP ON TOP OF ME AND CRAWL IN MY MOUTH AND I COULD CHOKE AND IT WOULD KILL ME IN MY SLEEP!!!"

So, in order to protect my children from a dangerous, potentially-lethal, 2-inch-long bug-eating lizard, I got a yardstick and tupperware container, and gently captured the menacing beast.

It's now out in the yard, where the bug hunting is likely better, anyway.

Sancho Panza, where are you when we need you?

I guess he's sort of a modern-day Don Quixote.

Thank you, Tanya!

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."