Annie's desk

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

Mr. Valproate: "I want to know why the doctor won't refill my seizure meds!"

Annie: "Let me see... I don't show that we have a request for that. Did you call your pharmacy?"

Mr. Valproate: "Yes! They told me they've sent it to Dr. Intern 3 times, and all she does is say that she doesn't prescribe my seizure meds. So why won't Dr. Grumpy refill it?"

Annie: "Why are they sending it to Dr. Intern? Did you ask them to fax it to Dr. Grumpy?"

Mr. Valproate: "No. Am I supposed to?"

Memories...

As readers know, my roommate for all 4 years of medical school was a guy named Enzyme.

Enzyme was about 6'3" and maybe 190 lbs. He was calm, cool, and confident, the perfect model of the U.S. Navy officer that he is today. Handsome and a ladies man. He knew how splendid he looked in his uniform. He loved the military, and didn't let anything alarm him.

Until one night.

It was, maybe, around 2:00 a.m. I'd gone to bed at midnight after giving up on studying for the day, and was in a deep sleep.

While I slumbered, deeply napping, suddenly there came a tapping, as of someone gently rapping, rapping at my bedroom door.

Med student Grumpy: "Hello?"

Enzyme: "Ibee, are you awake?"

Grumpy: "I am NOW. What's up?"

(silence)

Grumpy: "Are you okay?"

Enzyme: "I... Need your help."

Grumpy: "It's 2:00 a.m. What's going on?"

(silence)

Grumpy: "Enzyme?"

Enzyme: "There's a spider in my room."

Grumpy: "What?!!!"

Enzyme: "I said there's a spider in my room."

Grumpy: "What the hell? So squash it and let me sleep."

(silence)

Grumpy: "Hello?"

Enzyme: "I'm scared of spiders."

It wasn't even that big, FFS.

"Are you shitting me?"

Awesomeness

For those of you who don't follow Twitter, I'm going to have to put this up.

My random observation was good. But WhiteCoat's response made it great:

Senior citizens behaving badly

A "Neurology Update" sent out recently by MDlinx. Hazards of leaving the "T" out...

Thank you, Gene!

Postage stamps

While waiting in line at the post office yesterday, I saw this stamp in a machine:

I had a brief thought about trying trying to ask for one at the counter:

"I need a great sparkled fraternity. I mean, a freight spanked fickle lilly. No, wait, a crate mangled fritterfrilly. No? A great teutonic titterwilly? Trait-specific hereditary? Um... fate frazzled hillbilly? Razzle-dazzled pickled lorrie?

"Fuck it. I need a 70-cent stamp."

How not to get an appointment

Mary: "Okay, Mr. Suidae. Now, let me give you some forms... here's a clipboard, and a pen... I'll need to get a copy of your insurance card. Any questions?"

Mr. Suidae: "Yeah, will you go down on me?"


And no, folks, he had no neurological reason to act like that.

Beware of the Dragon

Seen in a vascular ultrasound:

"We're gonna need a really big ultrasound machine."

For non-medical readers: It should have said "left lower extremity."

Thank you, Homebru!

12:07 a.m.

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

Miss Myelin: "Hi, I'm a Multiple Sclerosis patient of yours, and I wanted you to know I'm in the emergency room. The doctor here is probably going to call you."

Dr. Grumpy: "Okay... Why did you go to ER?"

Miss Myelin: "I lost vision in my left eye. I didn't want to bother you, so I came right in. I was worried that I should get it checked out."

Dr. Grumpy: "Sounds like you did the right thing. Has the doctor seen you yet?"

Miss Myelin: "No, but they just got me back here."

Dr. Grumpy: "When did you lose vision in your eye?"

Miss Myelin: "About a month ago."

Dr. Grumpy: "A MONTH AGO? Why didn't you call me?!!!"

Miss Myelin: "Like I said, I didn't want to bother you."

Dr. Grumpy: "Did you start the MS medication, the Tyglatfiderexa, that I prescribed 2 months ago?"

Miss Myelin: "No. I don't know why you gave me that. I informed you at the first visit that I won't take narcotics."

Dr. Grumpy: "It's not a narcotic! I told you that. It's for your immune system. Who said it was a narcotic?"

Miss Myelin: "This lady I met."

Dr. Grumpy: "Is she a doctor?"

Miss Myelin: "No, she's the cashier at Qwik-Mart. But I think her boyfriend's dad is."

Back from the trenches

Frank and Craig returned yesterday from 10 days at Camp Befouled, where they did outdoors type stuff with other guys in the forests of northstate.

To the horror of all (except the boys) we discovered they were wearing the same clothes they'd left our home in 10 days earlier. And, on looking through their bags, we discovered no dirty clothes at all. Just neatly folded shirts, underwear, socks, etc. So they'd been wearing the same outfits, day and night, for 10 days.

They didn't seem to have a problem with this, but on the drive home Mrs. Grumpy and I sure did. In the high humidity of a hot day we had no choice but to keep the windows down so we wouldn't die. If I'd thought to bring some twine I might have just put them on the roof rack for the ride.

Upon getting home, even the dogs didn't want to get close to them. When you smell so awful your dog isn't interested... That's really bad.

We immediately directed them to the shower closest to the garage.

Weekend reruns

Dr. Unka is in my office building. When he refers a patient to me, he often walks them upstairs to my office and waits with them up front (while his own waiting room backs up) until Mary has scheduled the patient. He often asks that I drop everything I'm doing to come meet his new referral, instead of just, say, having them call us to make an appointment.

So today Mary grabbed me to say Dr. Unka was up front, and wanted me to come meet a new patient. So I excused myself from my current patient and went up front, to see him standing there with a familiar, somewhat irritated-looking, older lady.


Dr. Unka: "Ibee, I'd like you to meet Mrs. Ancient. I'm referring her for memory loss."

Dr. Grumpy: "Uh, I saw Mrs. Ancient 3 weeks ago for that."

Mrs. Ancient (glaring at Dr. Unka): "I told you! Why didn't you listen to me?"

Dr. Unka: "She did?"

Mrs. Ancient: "Yes!"

Dr. Grumpy: "Yes, I sent you a note."

Dr. Unka: "You did?"

Mrs. Ancient: "Yes! He did! It was even in my chart at your office! I pointed it out to you!"

Dr. Unka: "You did? Um, I mean, then have her make a follow-up." (leaves my office).


So, in this situation, who REALLY needs to be seeing the neurologist?

Thursday afternoon

Dr. Grumpy: "Hello, sir, I'm Dr. Grumpy. Have a seat... so what can I do for you?"

Mr. Thebaine: "My life is a never-ending orgy of pain and misery."

Ma-Ma-Ma Bell

 Mrs. Dementia lives with her daughter. She's on the ball enough to remember that she doesn't like me because I took away her driver's license, but that's about it. Anyway...


Mrs. Dementia: "Hello?"

Mary: "Hi, Mrs. Dementia. This is Mary, from Dr. Grumpy's office."

Mrs. Dementia: "Hi, Mary. You have the wrong number. I don't live here anymore."

Mary: "Okay, well, I'm calling to remind you about your appointment tomorrow."

Mrs. Dementia: "I won't be able to go. My daughter's car isn't working, and can't be fixed. I can't go to doctor appointments anymore."

Mary: "Is your daughter there?"

Mrs Dementia: "No, she drove to the grocery store because we're out of bread."

Mary: "Can you have her call me when she gets home?"

Mrs. Dementia: "She doesn't live here anymore, either. I don't know when she'll be home."

Mary: "Okay, I'll just call back later, thank you."

Mrs. Dementia: "You can't. Our phone is broken, and no one has been able to reach us for days."

Mary: "Does your daughter have her cell phone with her?"

Mrs. Dementia: "That's broken, too. I think you have a wrong number."

Mary: "Okay. Thank you. I'll try..."

Mrs. Dementia: "Our phone is broken, so don't try to call back. The grocery man told us it can't be fixed."

Daughter (picks up extension): "Hello? This is Sue. Mom, who are you talking to?"

Mrs. Dementia: "I'm sorry Sue, I think you also have a wrong number."

Mary: "This is Mary, at Dr. Grumpy's office."

Mrs. Dementia: "Our phone is broken, and we can't hear you."

Sue: "Hi, Mary. Is this about tomorrow?"

Mary: "Yes, at 2:45.

Sue: "We'll be there."

Mrs. Dementia: "You both have a wrong number because the phone is broken. I didn't hear it ring."

Mary: "Thank you. See you then."

Decimal points. Use 'em.

Seen in a hospital chart:

Thank you, Kim!

Stop!... Shovel time!

 While catching up on reading last weekend I came across this in a medical journal:


"The goal of the project is to supply an interactive system that translates vast amounts of data and scientific literature into insights that professionals can consult to inform their treatment decisions.

"A database, in this case big data, provides the foundation for the potential to use state-of-the-art analytics to generate truly actionable insights."


WTF does that mean?

This is the problem with modern buzzword bullshit. It is, like Macbeth said, "full of sound and fury, signifying nothing." Yet, medical journals are full of similar crap that tells you zilch.

EHR today is the same way. 5-page notes that automatically fill in what medications someone is on, what their allergies are, what their blood pressure is... yet only rarely do you find anything comprehensible telling you what the physician's impression and plan are- WHICH IS THE MOST IMPORTANT PART OF THE NOTE. Usually it's hidden in the ICD numeric codes, and oftentimes the "plan" says something like "see orders database." Which doesn't help me at all.

Quantity has replaced quality in medical writing, and the problem shows no sign of getting better.

The above collection of horseshit, BTW, was from an article about epilepsy treatment.

Rorschach

This is a neuron. It's the basic nerve cell that runs your brain, my brain, pretty much everything's brain:

Sometimes it's hard to leave my job at the office. Work is always on my mind.

One night, when I got home, I found my kids had spilled something in the kitchen. And it reminded me of...

Sigh.

June 6, 1944

"There have only been a handful of days since the beginning of time on which the direction the world was taking has been changed in one 24-hour period by an act of man. June 6, 1944, was one of them.

"No one can tell the whole story of D-Day. Each of the 60,000 men who waded ashore that day knew a little part of the story too well. To them the landing looked like a catastrophe. Each knew a friend shot through the throat, shot through the knee. Each knew the first names of five hanging dead on the barbed wire offshore, three who lay unattended on the beach as the blood drained from the holes in their bodies. They knew whole tank crews who drowned when their tanks were unloaded in 20 feet of water.

"There were heroes here no one will ever know because they're dead. The heroism of others is known only to themselves.

"What the Americans and the British and the Canadians were trying to do was get back a whole continent that had been taken from its rightful owners. It was one of the most monumentally unselfish things one group of people ever did for another.

"It's hard for anyone who's been in a war to describe the terror of it to anyone who hasn't. How would anyone know that John Lacey died in that clump of weeds by the wagon path as he looked to his left towards Simpson and caught a bullet behind the ear? And if there had been a picture of it - and there weren't any - it would've shown that Lacey was the only one who carried apples for the guys in his raincoat pocket.

"If you think the world is rotten, go to the cemetery at Saint-Laurent-sur-Mer on the hill overlooking the beach. See what one group of men did for another, D-Day, June 6, 1944."

- Andrew Rooney (1919-2011)

Medicine by committee

I'm with a new patient.


Dr. Grumpy: "What did the MRI show?"

Mr. Triad: "I'm not sure, my other neurologist said..."

Dr. Grumpy: "Wait, you have another neurologist?"

Mr. Triad: "Actually, I have 2 others. I saw both of them earlier this week."

Dr. Grumpy: "Why are you seeing 3 different neurologists?"

Mr. Triad: "Well, it seems like a good idea. I mean, this way if I disagree with something one does I can call the other two, and see what the majority opinion is."

Dr. Grumpy: "Who are the other 2 neurologists?"

Mr. Triad: "I don't want any of you to know who the others are. I think that will help keep all of you impartial."

Long pause.

Dr. Grumpy: "Honestly, I'm really not comfortable with this situation. I can understand someone wanting a 2nd opinion, or even a 3rd, but to have 3 different neurologists trying to manage the same condition, ordering tests, and prescribing medications at the same time... I'm going to have to end this appointment. I won't charge you for it, but I just don't think this is a good idea, and don't want to be a part of it."

Mr. Triad: "You know, that's funny. My 5th cardiologist said the same thing yesterday."

Great deals on prions! This week only!

Dear Major Chrysler, Jeep, & Dodge,

A reader sent me your flyer about the recent Memorial Day car & truck sale.

I can only assume you don't have a lot of customers who are neurologists...

Methinks I smell a rat

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

Mr. Gad: "Hi, I saw Dr. Grumpy a few years ago, and am worried about my records there."

Annie: "What's the problem?"

Mr. Gad: "Well, I'm concerned they might affect a legal action I'm in, and would like to change them."

Annie: "We can't change records, sir. If you feel something is incorrect you can send us a letter and we'll note it in your chart, or you can make an appointment to discuss it further with the doctor."

Mr. Gad: "That won't do. I need you to change my diagnosis."

Annie: "We can't do that."

Mr. Gad: "Okay... How about if you shred my chart and destroy any scheduling records, bills, and whatever that says I was there? I'll pay you, in cash, for your time."

Annie: "I'm sorry, sir, but that's illegal, and we can't do that."

Mr. Gad: "Don't you believe in 'the customer is always right'?"

Annie: "That's not the issue here."

Mr. Gad: "Thanks for nothing." (hangs up)

Numbers

How much did your employer give to charity last year?

Contrary to popular belief, American doctors and hospitals give away free care quite often, to the tune of $74.9 billion for 2013. That, in case you don't understand numbers, is a fuck-ton of money. Let's look at the zeros: $74,900,000,000.

Of course, most of it isn't voluntary. There are a lot of uninsured people in America, and, whether you like it or not, you're still paying for them (and always have been, long before the current health policies). Even though they don't have insurance, that doesn't mean they won't get sick or injured and land in the hospital. There they'll likely need labs, tests, medications, supplies, and (of course) doctors and nurses. Since the amount of money charged for medical services are realistically beyond what most can pay, the doctors and hospitals have no choice but to write them off as losses. So you pay for them by higher insurance rates (I've addressed this before).

But the office is a different matter. Most doctors, including me, collect payment up front. Maybe not the full amount, but we copy your insurance card and charge your $50 co-pay (or whatever) before seeing you. The rest we'll bill to your insurance company. For the record, I don't like billing people before their appointment, but it's amazing how many people have "forgotten" their wallet if you try to collect after the visit. Me and my staff have families to support, too.

My point here is that office care generally isn't free, unless previously arranged. To make an appointment you have to have insurance (or agree with our cash prices). Before you even get seen we copy your insurance card and charge you for your share.

Like most doctors, though, I still see the occasional uninsured patient for free. Sometimes as a courtesy to someone else, sometimes because I genuinely feel bad for someone and am trying to help. Most doctors do.

So how much free office care are U.S. doctors voluntarily giving up? Well, for 2013 it was $10.5 billion. $10,500,000,000. I'd still call that a shitload of money (shitload < fuck-ton).

For comparison, let's look at America's biggest retail company: Walmart. According to their own website, last year they gave away roughly $1 billion in cash and merchandise to various charities.

That's a lot, but it's not even 10% of the amount that doctors like me provided. Sam, you're a cheap-wad compared to us (but I love the way your shoppers dress).

Keep that in mind next time you hear some politician or "patient activist" talking about how doctors are all greedy bastards who don't really care about people. Maybe you should ask that person what they gave up to help others.

Odds are they don't have a 6-figure educational loan hanging over their fat heads, either.

Random weekend pictures

Okay, time to hit the mailbag for images you guys have sent in.


First, we have this delectable name for an alcoholic beverage:

If you can't make out the back bumper, it looks like "Drink Responsibly. Don't be an ass."



Next we have this name for a WiFi network:

The person who sent it in says she was on a street between a hardware store a nursing home. I'm not going to even try to guess.



Then there's this ad. Given the common slang definition of "dump" it doesn't sound like ANYTHING I'd ever want to eat, no matter what's really in it.

"I am NOT baking anything I just dumped."

Next, we have this strange command seen at a retail store:

"I'm tired of all this sex on TV. I keep falling off."

Mrs. Grumpy had me stop at Chipotle recently to pick up dinner, and I got this receipt:

Unfortunately, being a medical person, I erroneously read it as "Our guaiac rocks" and was (briefly) pretty horrified wondering what they're doing with guaiac in a restaurant.

Great reasons for referring a patient

"I get blurry vision when I watch TV. But only channel 7."

Head job

Recently, the Cefaly gadget was introduced. It's an electrical headband being promoted to treat migraines.

I'm not here to knock or praise it. I think the jury is still out, and have previously given my thoughts on the various electrical gadgets coming to market.

However, I can't help but notice there are a lot of promotional pics out there showing women (none of whom look anything like my patients) using this product:

"Do I look blissful enough? Is the Dalai Lama here yet?"

"The card you're holding is the 3 of hearts"

"Isn't this more artistic than touching my temples?"

OR

"The bells! The bells! They torment me!"

"Mine is blue. It matches my shoes. And that's all I'm wearing."

 

Anyway, after looking at these, I think they missed a chance to REALLY boost sales by putting a star in the middle. You know, something like this...

"The batteries are in the bracelets. They also deflect bullets."

Tangled

Annie: "Hey, Mr. Memory just called. Says he's still waiting for his Aricept refill?"

Dr. Grumpy: "Really? I thought I called it to DrugMart a few days ago."

Annie: "He says they never got it."

Dr. Grumpy: "Hang on... Here it is. Yeah, I called it in on Thursday."

Annie: "Let me call DrugMart."

(5 minutes later)

Dr. Grumpy: "What did DrugMart say?"

Annie: (sighs) "He picked it up yesterday."

The buzz

Eric

Last week Mrs. Grumpy bought a big jar of honey.

Yesterday morning we discovered one of the kids had put it in the freezer for no clear reason (and of course, no one admitted to it).

It had crystallized, so wouldn't go back to being a liquid easily. Since she didn't want to toss the whole thing, she scooped it into a pot and set it on the stove to liquify.

Then she got distracted with fighting kids, and forgot about it. So it boiled and went all over the stove and gave off a shitload of smoke. Which set off the smoke detectors, and then the fire alarm.

While the kids panicked like it was the apocalypse, I turned off the alarm, and she began cleaning the stove. The kitchen was filled with the sickeningly sweet smell of burning honey, so I sent the tribe to open the doors and windows and turn on ceiling fans.

Then suddenly the twins began screaming and running down the hall as, attracted by the smell, a bunch of bees came flying in. So I began killing them, and sent Frank to go close the doors.

He ran to get the front door, then yelled for me to come there. So I went up front and watched as a fire truck pulled into our driveway. Our alarm company had called them without even dialing the house to check.

I apologized to the guys, and explained what happened. I told them to ignore the twins, who by now had locked themselves in a bedroom and stuffed towels under the door to keep bees out, and were yelling out the window for the firemen to come help kill the bees. They laughed and drove off.

It took about 30 minutes to get rid of all the bees inside, but the smell was so strong we had to leave the windows open the rest of the day, during which time a bunch of them hovered menacingly outside the screens.

How was your weekend?

Memorial Day, 2014

Doris Miller was born in Waco, Texas, the 3rd of 4 boys. He worked on his father's farm until he was 19, when he joined the navy.

He signed up as a mess attendant, one of the few navy positions open to black men at the time, serving meals, cleaning, and doing other jobs. In January, 1940 he was assigned to the battleship West Virginia, where over the next year he was promoted to cook.

On the morning of December 7, 1941, The West Virginia was in Pearl Harbor. Miller had just finished serving breakfast and was starting to collect the officers' laundry for the day's washing. At 0757 the ship was struck by a torpedo from attacking Japanese planes.

Miller immediately ran to his battle station in the mid-ship anti-aircraft guns - only to find they'd been destroyed by a bomb. He took the initiative of going to the ship's central passageway, where he told any officer he could find that he was available for duty. The communications officer was looking for someone to help carry wounded men, and the 6'3", 200 pound Miller fit the bill.

They went to the bridge, where West Virginia's captain, Mervyn Bennion, lay dying outside from a large shrapnel wound. They carried him to a sheltered position. He refused to leave the bridge, continuing to give orders until he died.

Next, he was grabbed by 2 officers he routinely served meals to, and the 3 ran to an unmanned machine gun position. Miller had never operated the gun before, but learned quickly. Initially the officers planned to have him feed the ammunition belts to them, but while they were setting up he loaded a gun himself and started firing at planes.

The Japanese planes eventually left, with the West Virginia sinking to the bottom of the harbor 40 feet below. Parts of the ship were flooded, and Miller now set off to help the wounded. With portions of the deck covered in water and oil, he saved many lives by repeatedly carrying wounded men through the flooded areas to the dry quarterdeck, from where they could be taken ashore. When there was no more to do, he and the others finally left the ship.

A week later Miller was back at his usual mess job, this time on a heavy cruiser.

The initial roll of men who'd received commendations for their actions on December 7 didn't even have his name on it - just listing "an unnamed negro." It wasn't until March 12, 1942 that his identity became publicly known. In April, 1942 he was personally awarded the Navy Cross - the first African-American to be so decorated - by Admiral Nimitz himself. Nimitz wrote "this marks the first time in this conflict that such high tribute has been made in the Pacific Fleet to a member of his race, and I'm sure that the future will see others similarly honored for brave acts."

Miller's next assignment was the escort carrier Liscome Bay. On November 24, 1943 she was at the Battle of Makin Island. A Japanese torpedo detonated the ship's magazine, sinking her within minutes. Out of a crew of 916, only 262 men survived. Miller wasn't among them, and rests with his shipmates at the bottom of the Pacific.

He was 24 years old.

Thursday afternoon

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

Mrs. Time: "I need to make an appointment for Monday, May 26th."

Mary: "I'm sorry, but we're closed that day for Memorial Day. He can see you on Tuesday at..."

Mrs. Time: "That's not acceptable. Monday is the only day I can come in."

Mary: "I'm sorry, but we're going to be closed. It's a holiday."

Mrs. Time: "Well, then I'll meet him there. 10:00 in the morning should be okay. Tell him I'll be outside the building's western entrance."

Mary: "Ma'am, he's not going to come see you on a holiday. Do you have an emergency?"

Mrs. Time: "That's irrelevant. This is nonsense. Are you aware that it's violation of both state and federal law? Any doctor is legally obligated to see any patient whenever requested to do so."

Mary: "That's not true."

Mrs. Time: "I read it on the internet!"

Mary: "I'm not going to argue with you, ma'am."

Mrs. Time: "That's not acceptable, either."

Skool Nerse time

This is Mrs. Grumpy.

Now, I want to start by saying I'm glad no one was even slightly injured during yesterday's events, but I think this is a good time to review what happened, and how parents at Douglas C. Kenney Elementary School can learn from it. Even though there's only 2 weeks left in the school year, it's always important to go over basic safety.

As you all know by now, Mr. Ima Scumball robbed the convenience store across the street from the school yesterday morning, then (due to poor planning in not having a getaway car), unsuccessfully attempted to carjack a driver at gunpoint, then gave up and tried to escape on foot into the neighborhood. This all happened at about the same time classes were starting.

Obviously, this sort of activity is frowned upon by the Grumpyville Police, and so the area was quickly swarming with policemen, police cars, and a helicopter looking for Mr. Scumball.

Since there was a chance he'd try to get into the school to hide or take hostages, we were ordered to put the school on lockdown. So all gates were closed and locked, with no one allowed in or out. We even woke-up Elmer, our octogenarian security guard, from his morning nap.

Unfortunately, as always, the beginning of the school day is followed by stragglers who show up 10-15 minutes late, drop off their kids in front, and head to work. By the time they did yesterday, the gates were locked, and under lockdown protocol we aren't allowed to open them again until the all clear is sounded.

So, with policemen everywhere, more police cars arriving every moment to try and cordon off the area, and a helicopter hovering loudly overhead, it was reassuring to see so many parents doing the right thing: Dropping their kids off outside the locked gate and going to work.

Now, I personally don't leave my kids alone in an area where people with drawn firearms are chasing each other. Maybe I'm just overprotective that way. But it still seemed odd to me.

So, with your kids out there in the potential firing line, we can't let them in, either. Because that's the rule. We can't do anything to jeopardize the safety of the kids already inside the school. Calling on your cell phone as you drive away to say "Hi, the gate was locked and blocked off by a police car for some reason, please let Billy in." Isn't going to change anything.

I was particularly touched by some of the responses we got, when parents were told WHY the gate was locked:


"Really? Well, I still have to get to work."

"Wow. I hadn't heard it on the news. I'll go check again."

"I figured he was safe because there were cops everywhere."

 "Huh. Okay, call me if there's a problem."

"How long will he be out there? He had to pee when he got out of the car."

"Why can't you let him in? It's not like he's the robber. I can vouch for him."

"Oh, cool! Michael loves to play policeman! Will they let him help?"


Fortunately, Mr. Scumball was quickly caught hiding in someone's backyard, and we were able to let your kids in. However, I'd like to stress the key points here:

1. On the rare occasion the school gates are locked during the day, DON'T let your kid out of the car. It means something bad is happening.

2. Armed police everywhere is NOT a sign that the area is a good place for your kids.

3. The police are here to catch bad guys, not babysit your kids so you can go to work.

Thank you, and have a great summer.

You VILL have foot pain!

Hazards of misspelling "fasciitis:"

Making a point

Dr. Grumpy: "What's the pain like?"

Mrs. Bun: "It's stabbing, aching, burning, stabbing, throbbing, stabbing, itching, dull, stabbing, sore, stabbing, sharp... Did I mention stabbing?"

"Spam, spam, baked beans, spam, eggs, spam..."

Attention patients:

Those of you who've met Mary and Annie know my staff is pretty awesome. But, due to some recent confusion, I'd like to point out what my staff is NOT here to do:

1. Arrange tee times, make restaurant reservations, and look into available flights. We are not the hotel concierge desk.

2. Drop-off or pick-up your dry cleaning. This is not a service my practice offers.

3. If you have a letter to mail, and want Mary to put it with the rest of our outgoing stuff for her daily run to the mailbox, she doesn't mind. Asking her to look up addresses and postage rates, or to supply you with free stamps, is going too far.

4. Babysitting. This is a big one. WE ARE NOT HERE TO BABYSIT YOUR KIDS. Pissy and I only see adults, and consequently do not keep toys or copies of Ranger Rick in the lobby. We do not want your kids drawing all over our magazines, walls, and lobby furniture. Supervising them is also not the responsibility of other patients in the lobby - I see Alzheimer's patients, for fuck's sake. If you can't control your kids you will be asked to leave and given the option of rescheduling when you can get a sitter, or just seeing Dr. Darth across the street.

5. We are not going to help your kids with their homework. This is a medical practice, and my staff is busy. If junior needs a piece of scratch paper or to borrow a pencil, that's fine. But we are not here to teach spelling, algebra, or quantum mechanics.

6. Look up movie times. I mean, I can't remember the last time I saw a patient who didn't have a smart phone. There's an app for that. The fact that you handed your phone to a toddler to keep them busy is not an excuse.

7. We absolutely, positively, do not keep diapers (for ANY age) on hand. Either bring your own or hit the Target down the block. And DO NOT even think of changing them in our waiting room. There's a bathroom 15 feet down the hall.

8. Call your order over to Starbucks, Chipotle, or wherever. It's not like you even offered to treat us.

9. Give advice on pet care. We are not the vet. They are 2 blocks over, and do a great job. The fact that between us the staff has 8 dogs does not make us an animal hospital.

10. Pick up your trash. There's a trash can out in the lobby. Leaving the detritus of your McGrease lunch or little balls of snot-loaded tissues on the lobby table is rude, gross, and unacceptable.

11. Find you a pharmacy, or therapy place, or hospital, or pretty much anything in Montana. Or Canada. Or South America. Or anywhere outside of Grumpyville. Let's face it, we have enough trouble figuring out what pharmacy to call HERE when you give us directions like "it's near the place with blue awnings," "the one by the Denny's," and (my favorite) "across the street from the homeless guy in the baseball hat."

12. Call numbers you got from Craigslist of people selling furniture, clothes, themselves, etc., then reporting back to you on what we found out.

13. Buy shit that your kid is selling for a school fundraiser. Don't even go there. You wouldn't like it if we hit you up for cash outside of your office co-pay.

14. Answer your cell phone while you're with the doctor, and take messages. They do this all day for me, and I'm paying them. You are not. It can go to voice mail.

Thank you.

Ibee Grumpy, M.D.

Guest post

Dr. Coogie writes in:


Last night I got called down to ER to admit a guy for syncope.

Dr. Coogie: "What happened?"

Mr. DUI: "Well I was drinking beer at Boobpile and I passed out."

Dr. Coogie: "How long were you out?"

Mr. DUI: "Not sure. I woke up on the floor with everyone around me, but then realized I still had more beer to finish, so I had some more beer and decided I should get checked out."

Dr. Coogie: "Okay, and then you had someone bring you here?"

Mr. DUI: "No, I had spilled beer on my clothes so I drove home to change, then drove to the ER, and here we are."

Meeting of the minds

With the school year winding down, the twins are off to Wingnut Elementary's end-of-year school music camp, to spend 4 days in the cool pines of northstate. There they'll practice their instruments, terrify wildlife, irritate hunters, and likely violate the endangered species act.

So Tuesday afternoon was the parents' meeting with the teacher leading the expedition. It was allegedly mandatory (though they didn't take attendance). Mrs. Grumpy had happy hour a meeting at her job, so I went.

I got there early, and, out of habit (amazing how we default in a classroom), took my traditional college/medical school seat (3rd row from the front, 2nd seat in). Other parents came in. A cardiologist I know, whose daughter is in the same class, came in and sat next to me.

As Mr. Allegro was trying to get the SmartBoard to work (this involves tapping it, swearing, hitting it harder, swearing, tapping it lightly, swearing, wash, rinse, repeat) Mrs. Mysomom came in. She carefully looked over several seats before selecting one that met her standards, and started to set her purse down. Then she stopped, whipped out latex gloves, put them on, pulled out a pack of bleach wipes and began scrubbing down the desk and chair (which weren't visibly filthy) before tossing the gloves and wipes in the trash and Purelling her hands.

After a few minutes the presentation began. Mr. Allegro showed us a brief video about the camp (which looked like a lot of fun, BTW), went over some rules and other points, and finally opened up the floor for questions. Boy, that was a stupid idea.

Mom 1: "It says here that no electronics are allowed. What about phones?"

Mr. Allegro: "No phones. They distract the kids from the lessons. We also don't want the boys and girls texting each other after lights out."

Mom 1: "But then how am I supposed to know where you guys are, and that you arrived safely?"

Mr. Allegro: "Either Mrs. Hendrickson or I will send a group text to all of you when we get there."

Mom 1: "Yeah, but what if something happens to both of you, like you're killed in a bus crash on the way, and the kids need help?"

Mr. Allegro: "Well, the driver also has a phone, and the bus has GPS and a radio connection to its company."

Mom 1: "It's very important that I be aware of where Sherman is at all times, 24/7. I'm his mother, you know."

Mr. Allegro: "He'll be with us, and you'll be notified if there are any problems."

Mom 2: "Wait a minute. You're not driving the bus?"

Mr. Allegro: "No, the bus is chartered from Pinto Transportation, who supply the driver."

Mom 2: (getting out paper and writing notes) "Who is the driver? What are his home and cell phone numbers?"

Mr. Allegro: "I don't know. They..."

Mom 2: "You don't know? Do you know anything about him? Does he have a police record? Is he in good health?"

Mr. Allegro: "Well, I have to assume..."

Mom 2: "You mean he might not be? THIS IS THE PERSON RESPONSIBLE FOR MY DAUGHTER'S LIFE AND YOU DON'T KNOW ANYTHING ABOUT HIM? I'd like to see his medical records before the trip. Have them sent to my home fax. Get his name so I can Google him, too."

At this point a parent wandered in late and asked a few questions that had already been answered during the initial presentation, visibly annoying everyone

Mom 3: "What about the bus? Is it new? Old? Have a history of accidents?"

Mr. Allegro: "The company supplies the bus, and I don't know which one we'll..."

Mom 3: "So for all we know it was recently in a major accident and has shitty brakes. That's SO reassuring. Can we review its maintenance records in advance?"

Mr. Allegro: "Uh, you'll have to call Pinto Lines."

School janitor walks in, is surprised to see people in the room, apologizes, leaves.

Mom 4: "What is the closest hospital and emergency room to the camp?"

Mr. Allegro: "Uh..." (grabs a notebook) "West State Regional Hospital."

Mom 4: "Is it a Level I Trauma center?"

Mr. Allegro: "It has an emergency room. What does 'Level I Trauma' mean? I'm just the music teacher!"

Mom 5: "Do you know if it has board-certified physicians? Michael is always falling off roofs."

Mr. Allegro: "The kids aren't going to be on the roof. They're not allowed there."

Mom 5: "That won't stop Michael. Where there's a roof to fall off of, he'll find a way."

Mom 6: "It says here the kids aren't allowed to bring firearms, tobacco, alcohol, or illegal drugs?"

Mr. Allegro: "Correct. Those will be provided there."

Me and the cardiologist crack up, the others glare at us. Mr. Allegro regrets having tried to joke.

Mom 7: "Why can't they have their phones on the bus at least? It's a 4 hour drive"

Mr. Allegro: "Because we don't want them brought at all. The bus has TV screens, like on planes, and we're taking movies to watch."

Another parent comes in late, asks the same questions that had already been answered during the initial presentation and for the first late parent, further annoying everyone.

Mom 3: "What are the movies rated?"

Mr. Allegro: "G and PG. I think we have 'Wreck-It Ralph,' 'Frozen,' 'Monsters University,' and "Despicable Me 2.' "

Mom 3: "Doesn't 'Wreck-It Ralph' promote violence? I think I read that in Crazyfuck Parent Today."

Mom 2: "No, it doesn't. Besides, from the way your daughter treats mine I'm pretty sure she's used to violence."

School janitor walks in again, is still surprised to see people in the room, apologizes, leaves.

Mom 7: "I don't want Cindy to see 'Frozen' again. She'll come home singing that stupid song that makes me want to slit my wrists."

Mr. Allegro: "You're certainly welcome to send any DVD's of G and PG movies you want, and I can let the kids vote on it."

Mom 4: "These kids are only 12. They're not old enough to make decisions like that."

The cardiologist takes 2 chocolate bars out of her purse, offers me one. A lady behind us says "you're doctors and you eat that shit? Remind me to never come to you." We both ignore her.

Mom 8: "Susan gets headaches a lot, so I want to send her with a bottle of Tylenol. Is that okay?"

Mr. Allegro: "Sure, just fill out the medication form that was in your packet. There's a full-time nurse at camp, too."

The cardiologist whispers to me "Rachel takes Adderall. I thought about writing on the form that the teacher should give it rectally to see what they'd do, but Rachel would never speak to my again." We both snicker, other parents glare.

Mom 5: "How do we know it's really Tylenol, and your daughter isn't selling something?"

Mom 8: "Really, Beth? You should pay better attention to your own son's issues."

Yet another parent comes in late, asks the same questions that had already been answered during the initial presentation and 1st & 2nd late parents, further annoying everyone.

Mom 9: "Is the camp nut-free?"

Mr. Allegro: "Yes. Please don't send snacks with your kids, they'll be provided for them."

Mom 3: "Is your son allergic to nuts?"

Mom 9: "Not that I know of, but I keep them out of the house anyway in case he becomes allergic."

Janitor walks in again, is still surprised to see people in the room, apologizes, leaves. Cardiologist whispers "Is he one of your dementia patients?" Lady in front of us turns around and goes "Shhhh!"

Mom 10: "What about gluten free?"

Mr. Allegro: "No, but we can make arrangements. Does your daughter have Celiac disease?"

Mom: 10: "No, she tested negative, but I still won't let her have gluten. I read that it's being put into foods as part of the government's secret eugenics program."

The cardiologist grabs and squeezes my forearm so hard that she draws blood, I kick her under the table. Lady next to us thinks we're playing footsy and looks disapprovingly. I briefly consider pretending the twins are Kosher just to liven up the party.

Mom 11: "Will you guys be in tents?"

Mr. Allegro: "No, it's a dormitory with 2 wings, girls on one side, boys on the other. The adults will be in the hallway between them."

Mom 1: "Does it have fire sprinklers?"

Mr. Allegro: "Uh, I think so..."

Mom 1: "Are the safety inspection certificates online, where I can see them?"

(School janitor walks in again, is still surprised to see people in the room, apologizes, starts to leave. Cardiologist grabs my arm, drags me out after the janitor).

Janitor: "Can I help you?"

Dr. Cardio: "No, we just needed to get out of there."

Dr. Grumpy: "I think you broke my arm."

Dr. Cardio. "I don't care. I couldn't take it anymore. And you couldn't, either."

Dr. Grumpy: "No shit."

Janitor: "Moms today get crazy at these meetings. They'll be there all damn night."

Click

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

Ms. Cell: "I've tried calling your office 5 times today, and the calls keep getting dropped."

Mary: "I'm sorry. What can I help you with?"

Mrs. Cell: "You could get your phones fixed so they don't keep dropping my calls!"

Mary: "Ma'am, usually that's not at our end..."

Mrs. Cell: "Of course it is! I call your office from my cell phone, and the call gets dropped. You think that's a coincidence?"

Mary: "Have you tried calling from a land line?"

Mrs. Cell: "So now you're saying it's MY fault? Is that it?"

Mary: "No, but..."

Mrs. Cell: "Look, I need to..."

(silence)

Gender pronouns

Seen in another doctor's note:

Before you write in - the patient hasn't had gender reassignment. Simply a doctor who doesn't proofread.

Overheard in the living room

Craig: "Did the girls have a sex ed lecture today?"

Marie: "Yeah, in the classroom at the back of the library."

Craig: "We were in the cafeteria classroom. Ours showed all these disgusting pictures of sex diseases."

Marie: "Yeah, the nurse made us look at those. They were gross. One thing looked like a vagina with an eyeball on one side."

Craig: "We had this one picture. I thought it was, like, a really burned and infected tongue, but then Mr. Cooper said it was a diseased penis. It was so gross. Jacob Myers ran outside and threw up in the grass."

Marie: "Was that near the back door of the cafeteria?"

Craig: "Yeah, why?"

Marie: "The nurse stepped in it when we were going back to our classrooms, and began swearing."

Craig: "That's gross, too."

Marie: "Her shoe was all covered with barf."

Craig: "Yuck."

Marie: "Cindy put a picture of it on FaceBook."

Walking in New York

The Colbert Report
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Great attending quotes from training

"If a patient demands to have daily office appointments with you, let them. They're the ones paying for it, and you have to be there anyway. They'll get bored and stop after 1-2 weeks. This is a war of attrition, and you'll always win."

Free

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

Mr. Gratis: "Hi, I need to see the doctor."

Mary: "Okay... We have an opening tomorrow at 2:30. What insurance do you have?"

Mr. Gratis: "I don't have insurance."

Mary: "All right, our cash prices are..."

Mr. Gratis: "Oh, there's no charge for the visit. I was referred by Boondock Hospital."

Mary: "What?"

Mr. Gratis: "I was seen in the ER at Boondock Hospital last week, and they told me I should see a neurologist. Your name was on the list they gave me."

Mary: "Yes, but we still charge for the visit."

Mr. Gratis: "It's supposed to be free. A hospital referred me!"

Mary: "I understand that, but it doesn't mean we don't bill for our services."

Mr. Gratis: "I can give you the name of the doctor there. Can you bill her? Or the hospital?"

Wonder powers activate!

Medikidz is a company that sells medical comic books for kids.

I get it. I was a kid once, and loved comic books. In fact, I think there were educational ones at my pediatrician's cave office then, so I'm glad they're still using them today. (I just wish there'd been a good one for biochemistry during med school).

These are the Medikidz superheroes:

I haven't read the comics, but it looks like they fly around on a giant red corpuscle. Being a neurologist I kind of like the knobby-kneed brain in the background. I'm not sure what to make of the guy in front, as generally I prefer my superheroes to wear pants. There's also the guy behind him on the left, who's carrying eating utensils in his belt. This is not standard JLA equipment.

Anyway, the reason I'm even on this subject is that recently the annual Neurology meetings were held in Philadelphia, and my top field agent, SMOD, was there.

Like many companies, Medikidz had a booth on the exhibit floor. I've seen my share of these. Pleasant sales reps in professional attire extolling the virtues of whatever they're selling.

But not Medikidz. To SMOD's horror, their reps were wearing the superhero outfits:

"For this I got a college degree."

They look kind of lonely. It's good to have a job, but still pretty humiliating to have to be at an adult medical convention wearing spandex and a cape. Normally you only see this kind of outfit on Halloween, when shopping at Walmart, or in the personals section of Craigslist.

Dear Medikidz: if you want to attract neurologists, you should wear Star Trek costumes.

Relevance

On the fax machine yesterday morning was a note from Dr. Intern's office, about a lady who has an appointment tomorrow.

It said: "Please evaluate Flora Betapir for Alzheimer's disease. Records attached."

The attached records were:

Right hand x-rays from 1999

A mammogram report from 2002

and a Pap smear report from 2005

Sigh.

True colors

Last week, for those of you who missed it, Los Angeles Clippers owner Donald Sterling temporarily became the most hated man in America. This is actually pretty impressive, as it involves leapfrogging over politicians, television pundits, lawyers, doctors, and the barista who can never get your order right.

Mr. Sterling's downfall came because of overtly racist statements. This rapidly brought him condemnation from politicians, celebrities, and pretty much anyone with a microphone or Twitter account. People lined up around the block to announce they would boycott Clippers games if he wasn't removed, and team sponsors jumped ship fast.

So, guess who can't boycott Mr. Sterling? I can't. Or anyone in the healthcare field.

Sure, I can refuse to go to his games, or live in one of his buildings. But if he shows up in my office or hospital, I wouldn't turn him away. And neither should any doctor or nurse.

This is one of the hardest things in medicine. Regardless of how we may feel about a person, or disagree with their beliefs, we still have to do our best to help them when they need us. I've taken care of neo-nazi white supremacists, militant black supremacists, dirtballs who shoot police or kill innocent people just because they don't like them... the list goes on. Sterling's condescending boardroom racism is minor league compared to these guys.

It's part of the job. Whether they come to you in the office, or you're seeing them in the hospital, you have to set aside your personal feelings and do your best to help. Dr. Samuel Mudd spent 4 years in prison for providing medical care to John Wilkes Booth - a conviction yet to be overturned.

I never discuss politics with patients, as it's bad for the relationship. But that doesn't stop some from bringing it up, sometimes expressing blatantly racist or antisemitic views. I've had people tell me all blacks should be shipped to Africa, or Jews or homosexuals killed. Do I agree with this? Hell no. But I also believe that part of being a doctor is caring for anyone who seeks my help, regardless of personal feelings for them.

In hospitals they have it even worse. Nurses and doctors there have to deal with people who are drunk, high, verbally abusive, and sometimes violent. And, again, they do their best to help those no one would want to. As professionally as possible.

Like most people these days I don't support or like Mr. Sterling. But that wouldn't stop me, or any number of doctors, nurses, or paramedics from doing our best to help him if he needed us. Because that's what we do.

Overheard in ER

Dr. Urgent: "What brings you to ER today?"

Mr. Couth: "I got a big, huge, ball of shit in my ass and it fucking hurts."


Attention medical students: we at Dr. Grumpy, Inc., will not be held responsible for your grades if you use the above quote when presenting a case to your attending.

Wednesday afternoon

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

Dr. Equine: "Hi, thanks for calling me back. I'm a horse veterinarian at Grumpyville Racetrack. Do you have a patient named Mr. Adipose?"

Dr. Grumpy: "Uh, yeah... I just saw him this morning."

Dr. Equine: "You ordered an MRI on him?"

Dr. Grumpy: "Um... What does this have to do with the racetrack?"

Dr. Equine: "I'm going to guess he's a large fellow."

Dr. Grumpy: "Why..."

Dr. Equine: "He just called my office to see if we had an MRI for horses he could use."

Hey, it's for a good cause

Previously I've featured such tasteful fundraisers as:

The Alzheimer's Association "Night to Remember" ball

and

A Parkinson's support group's "Shaken, not Stirred" happy hour.


Now, thanks to a reader submission, I've found:

Thank you, M!

Fly me to the moon

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

Ms. Pisces: "Hi, I need to get in to see Dr. Grumpy right away!"

Mary: "Well, you're in luck. We just had a cancellation, and he can see you this afternoon..."

Ms. Pisces: "Oh, no. It will have to be next week. My astrologer says the horoscope doesn't favor an appointment this week."

Groundhog Day

A few weeks ago I wrote about the recent disclosure of Medicare payment data to the public. I finally got around to running my own numbers from it, and found my total take was around $70,000.

Now, normally I don't care how much other docs are getting. I try not to pay attention to those things, as it's none of my business. But, due to a recent news story, I decided to look up the stats on another doctor.

The doctor in question is an interventional cardiologist, practicing in the northeast. His father is also a cardiologist, and they work together. Sounds nice huh? A family-run medical group.

Anyway, per the 2012 Medicare data, that year Uncle Sam paid this gentleman $313,375.23. DISCLOSURE: I suck at math. Really. So this number could be completely wrong since I had trouble making sense of which column was which, and then I had to multiply across, then add.

Now, like I previously pointed out this is gross, not net. Like all of us out there, I'm sure the good doctor has insane office overhead to cover. This guy is in a field, unlike mine, where you truly are saving lives, and you can't put a price on that. And I'm also not in the business of telling other people how to spend their money. After all, I blow most of my immense fortune on a Diet Coke habit.

So what does this successful cardiologist spend it on? Well, he supports local businesses by spending $135,000 at a strip bar.

I am not making this up.

"I need it all in singles. Don't ask why."

Granted, this wasn't all at once. It took him 4 visits over 10 days last November at Scores Gentlemans Club to reach that amount, averaging $33,750 per visit. It was a cold winter, and I think we all needed to warm up (at the Grumpy household we cranked the heater up and got out extra blankets). Perhaps it was national "Support your local strip bar week" (if it was, I missed the memo).

I haven't been to a strip bar since a bachelor party in residency, but don't think I could spend that much on drinks, tips, and lap dances if I tried (although I haven't tried, either). Maybe I wasn't going to the right bars.

But it gets better. The good doctor (Zyad Younan, M.D.) put the charges on he & his dad's business credit card. Can you imagine how proud the elder doctor Younan felt when the AMEX statement came in? "EKG supplies, ultrasound gel...  $135,000 at The Boob Palace? ZYAD!!!"

Regrettably, daddy's reaction to his prodigy's spending habits hasn't been in the news. He probably grounded him and took away the car. These things don't look very good on IRS audits.

I'm really not sure how Dr. Younan, Jr. was planning to claim this as a business expense. Granted, he's a heart doctor, and the heart is located in the chest, and I'm sure there are a lot of chests displayed at Scores. Perhaps it was a research project he was working on ("I want to put my stent in your vessel"). He could also have been recruiting a new partner, though not necessarily for the practice.

"You say it's a study to repeatedly check my femoral artery pulse?"

So, to recap thus far: a successful cardiologist blew $135,000 in 4 visits at a strip bar, using his business AMEX.

But wait, that's not all!

As anyone who owns a credit card knows, sooner or later the card company wants to get paid (they're funny like that) and sent a bill to Dr. Younan. Like any honest, law-abiding, boob-ogling, dad-fearing cardiologist, he should pay it, right? And, if he had, none of this would even have made the newspapers.

But he didn't.

Instead, he claimed that he didn't have to pay because he was drugged. EACH TIME (I assume he means something beyond alcohol) and therefore has no recollection of being there.

Now, this, in my opinion, is pretty far-fetched. Okay, maybe once is semi-believable. I mean, stranger things have happened. One minute you're walking out to the doctor's lot, the next you're waking up and finding out you spent a fortune at a strip club. Maybe it was aliens. Or terrorists. Or your ex.

BUT 4 TIMES? I mean, that's one seriously good drugging job. If I'd blown that kind of money in a strip bar, I'd at least like to remember what I got for it. But not this unfortunate fellow. Whatever they used to drug him must have been pretty strong to make him not only forget, but to return to the same place 3 more times. Holy déjà vu, Batman!

"It's February 2nd, and I've been drugged by a stripper. Again."

The good doctor's refusal to pay is so steadfast that Scores has filed suit against him for the amount. They claim to have video of him in their fine establishment, acting, I assume, somewhat coherently. To date I haven't seen it listed on Youtube.

So, in summary:

1. No matter what Medicare actually pays your doctor, IT'S NOT WHAT THEY'RE TAKING HOME. The overhead for a medical practice is higher than you think. Probably much higher.

2. Don't let that hair-netted lady who puts out the bagels in the doctors lounge slip something into your coffee. You never know where you'll end up, sometimes repeatedly.

3. If you want to go to a strip bar, more power to you. But trying to charge it to your dad's business AMEX card may not be a good idea.

4. What you do with your hard-earned money is up to you, but remember to pay the bill. Because if you do, they won't sue you to get their money, and this sort of thing won't end up in the news.

5. $135,000 is a helluva lot of money to blow at a strip bar. I think my record was $50 for my share of the bachelor party.

Weekend reruns

From 2009:


Today ended with me doing a telephone and internet conference with 15 other neurologists across the country to review data on a drug that's in development.

The meeting took place after we were all home. So you'd hear the occasional sounds of home life. A kid yelling, a dog barking, somebody laughing in the background, etc.

Usually these things go fairly smoothly. Tonight's, however, had 2 noteworthy interruptions:

Interruption #1:

The "click" of a receiver being picked up, and suddenly a young female voice cuts off the moderator:

Young female: "Daddy! My boyfriend is supposed to call tonight! Why are you on the phone?"

Neurologist X: "Britney! Get off the phone NOW! I'm in a meeting!"

Young female: "Daddy! This isn't just any boy! This is TREVOR!!!!!!!!!!!!" (click)



Interruption #2

The moderator was asking a few questions. He was interrupted when a neurologist with a New York accent apparently had an interruption at home, and loudly said:

"What? Tell him to fuck off! I'm on the phone!"

Seen in a hospital chart.

No. I have no idea what #4 means.

Striptease

Mr. Larsson is sitting in the lobby, reading old issues of People, during his wife's appointment. Suddenly he walks up to Mary's desk, holding a small plastic box.

Mary: "Can I help you, sir?"

Mr. Larsson: "Do you have a land-line?"

Mary: "Yes."

Mr. Larsson: "I need to make a call, and can't use a cell phone."

Mary: "Okay, that's fine, just come around the counter there."

He sets the plastic box on the counter, comes over to the desk, and starts unbuttoning his shirt.

Mary: "What are you doing?"

Mr. Larsson: "I need to send a pacemaker report to my cardiologist's office, and we don't have a land-line at home."

He tosses his shirt on a chair and starts attaching clips from the box to his chest. 

"Wanna see the scar?"

Mary: "Um, I don't know how to send a pacemaker report..."

Mr. Larsson: "Can you unplug one of your phone lines and hand me the cord?"

Mrs. Larsson and I finish her appointment. She opens my office door and walks up front.

Mrs. Larsson: "ARNE! PUT YOUR SHIRT ON!"

Mr. Larsson: "But I need to..."

Mrs. Larsson: "NO! I told you, we'll stop at Dr. Senning's office tomorrow, and you can do it directly. You don't need to do this today!"

Mr. Larsson: "But Dr. Grumpy has a land-line!"

Mrs. Larsson: "So does Dr. Senning! Here's your shirt! I'm sorry, Mary, he's just very obsessive about this."

They leave. The door closes. Mary and I stare blankly at each other for about 10 seconds. Then collapse in hysterics.