Annie's desk

Annie: “Dr. Grumpy’s office, this is Annie.”

Ms. X: “Hi, I was wondering if I could talk to Dr. Grumpy, I have a medication question?”

Annie: “Well, can you tell me…”

Ms. X: “I just need to know, hypothetically, what would happen if someone stopped Ozbixacu abruptly in a 9-year-old boy.”

Annie: “Dr. Grumpy doesn’t see anyone under 18. Are you a patient? Who is this?”

Ms. X: “My name isn’t important. I need an answer. Now. Either give me the answer or get the doctor on the phone.”

Annie: “Look, I can’t just…”

Ms. X: “I am so done with you so-called medical people.”

Click

Random pictures

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

First, from the Guardian Angle Department:

Next is this lodging establishment:

 

Here we have a recycling can, apparently for people with partial bisection injuries (I don't think Darth Maul counts as "partial").

One reader says she discovered this uplifting decor at her dentist's office:

And, lastly, nurse Jenn says this drawer is in the galley of the nurses station she works at:

 

In memoriam

This is the launching of the aircraft carrier HMS Queen Elizabeth, July, 2014.

Photo credit AP

 

This is the launching of the battleship HMS Prince of Wales in May, 1939.

 

 

If you look carefully, the same lady is in both pictures:

 

 

 

Seen in a chart

 

Friday afternoon

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

Debbie: "Hi, it's Debbie, Dr. Nerve's office manager. Are you going to be covering his new partner, Dr. Axon's, hospital patients this weekend?"

Dr. Grumpy: "Does he have any hospital patients?"

Debbie: "No. He doesn't even have hospital privileges yet, so he won't have any hospital patients."

Pause

Dr. Grumpy: "Then why are you asking?"

Debbie: "Because Dr. Nerve told me to."

Undercover Angel

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

Mr. Bedsheet: "My wife says I kick in my sleep."

Lady Bedsheet: "He does! About an hour after he dozes off his legs start thrashing around, and it keeps me up."

Dr. Grumpy: "Do they..."

Lady Bedsheet: "Actually, I took a video of him doing it last night. Would that help?"

Dr. Grumpy: "Sure, why don't you put it on and I'll have a look."

Lady Bedsheet: "Let me get my phone." (rummages in her purse)

Mr. Bedsheet: "Doc, do you mind if I come around to that side of your desk? I want to see what it looks like myself."

Dr. Grumpy: "That's fine, why don't you stand right there." (I took a swig of Diet Coke)

Lady Bedsheet: "Okay, this woke me up just after midnight last night, you can see them kicking here..."

(I suddenly tried desperately not to blow Diet Coke all over her phone)

Mr. Bedsheet: "WHAT THE FUCK, HARRIET? WHY IS THAT IN THERE?"

Lady Bedsheet: "What was I supposed to do? You always sleep in the buff."

(I managed - barely - to get the Diet Coke down) 

Mr. Bedsheet: "YOU COULDN'T HAVE TAKEN IT FROM A DIFFERENT ANGLE?!!!"

Lady Bedsheet: "A different angle? Who am I, Spielberg?"

Mr. Bedsheet: "WHY DIDN'T YOU PUT A SHEET OVER MY CROTCH OR SOMETHING?"

Lady Bedsheet: "Look, Dr. Grumpy is a doctor. I'm sure he looks at schlongs all day in his job."

Mr. Bedsheet: "He's a brain doctor! They don't look at schlongs!"

Lady Bedsheet: "Dr. Grumpy, is this true? Do brain doctors look at schlongs at work or don't they?"

Dr. Grumpy: (desperately trying to regain control of the appointment) "Um, how many nights a week does this happen?"

Mr. Bedsheet: "What? That she films my schlong? Apparently at least once."

Lady Bedsheet: "Harold, can you stop saying 'schlong'? I'm sure the doctor would prefer a more medical term."

Mr. Bedsheet: "I think he'd prefer you go sit in the waiting room."

Lady Bedsheet: "Fine. Dr. Grumpy, did you see enough of the video to understand what's going on?"

Dr. Grumpy: "Most definitely."

Mary's desk

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

Ms. Cricetinae: "Hi, um, can Dr. Grumpy work me up for fur, I mean hair, loss, and weight changes?"

Mary: "No, you'll need to call your family doctor for that."

Ms. Cricetinae: "Well they won't see me for it."

Mary: "Well, I don't know what to tell you there, but Dr. Grumpy doesn't..."

Ms. Cricetinae: "Okay, the truth is that it's my hamster, Tulip. He's been losing weight, and fur, and I think he needs his thyroid checked and other stuff, but I don't want to pay for a vet. Can't Dr. Grumpy just draw the labs and bill them under my name to my insurance and say they were for me?"

Mary: "No, we can't do that. It's fraud. And Dr. Grumpy doesn't see hamsters, or know much about them."

Ms. Cricetinae: "But what about Tulip?

Mary: "Take him to the vet."

Ms. Cricetinae: "Thanks for being totally useless."

Click

Saturday night, 8:24 p.m.

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

Mrs. Cartography: "Hi, I'm sorry to bother you on a weekend, but I'm on vacation and I guess I forget to bring my Fukitol pills."

Dr. Grumpy: "Okay, do you have a pharmacy you want me to call it to? Where are you?"

Mrs. Cartography: "I'm in Hawaii, in... hang on. It says this is Lahaina. Do you know a pharmacy here?"

Dr. Grumpy: "No but let me..."

Mrs. Cartography: "My phone says there's a Dumpster Drug in Honolulu. Can you send it there?"

Dr. Grumpy: "Yes, are you going there soon?"

Mrs. Cartography: "It wasn't planned, but I can if I need to. We have a rental car."

Dr. Grumpy: "Honolulu is on another island. You're on Maui."

Mrs. Cartography: "I know Hawaii is an island. I'm not stupid."

Dr. Grumpy: "It's several islands, and Lahaina and Honolulu aren't on the same one. Let me look up a pharmacy in Lahaina for you, hang on..."

Mrs. Cartography: "Well, I'd rather go to Dumpster Drugs, because I use them back home. Why don't you just call it in and we'll drive there tomorrow?"

Dr. Grumpy: "You can't drive from Lahaina to Honolulu."

Mrs. Cartography: "I'm sure you can, there must be bridge or something. I mean, that's what I do when I'm going to Brooklyn."

Dr. Grumpy: "It's not quite the same. Let me..."

Mrs. Cartography: "Oh, never mind. My husband found the Fukitol bottle in my purse. Have a good weekend, doctor."

Memories

Going through some old emails over the weekend, I found this one to my office staff. I wrote it roughly 10 years ago, during a family trip to Disneyland.

While waiting to get in this morning we passed a lady yelling at a park employee outside a ticket booth. She was quite upset that the "special Disneyland admissions" she'd bought for a few $100 bills wasn't going to get her into the park. Or anywhere.

Lady: "I demand you honor these tickets! They say they're official tickets, and I paid good money for them."

Employee: "Ma'am, I'm sorry, but these aren't tickets. Did you get them at your hotel desk?"

Lady: "NO! The desk was ridiculously expensive. These were much cheaper. I got them from a man selling them at the bus stop in front of my hotel."

Employee: "I think you've been scammed. I can call the police if you wish. He wasn't a Disney employee, and these aren't real tickets."

Lady: "Of course they're real! They have a picture of Mickey Mouse on them."

Employee: "Yes, but that doesn't make them real tickets. In fact, that's a decal of Mickey stuck to them. It looks like they were made on a home computer."

Lady: "Well, he SAID he was an authorized Disney ticket sales person, and was wearing a hat with Goofy on it. Why would he lie about that?"

Beware of the dragon

 Seen in a chart:

Wait, what?

Pissy and I are talking to a drug rep.

"So, doctors, this nasal spray contains batsonshazam, that can be used emergently to stop a seizure, or attack of seizures. It comes 2 units in a box, which is convenient, as it allows patients to keep one at home and one at work, or one in the car, so they can even use it if they have a seizure and lose consciousness while driving."

Guidance

So today, me, and pretty much every doctor, veterinarian, nurse practitioner, and pharmacist in the country got this email:

Apparently the folks at the DEA (Drug Enforcement Administration) decided that people reading the rules about guidance didn't have enough guidance, and so needed some guidance. Or they just made a bet over the weekend on who could use the word "guidance" in an email the most:

 

 

Isn't that impressive? Okay, so what does the guidance in this remarkable document on guidance say? I'm glad you asked!

Here's page 1 (page 2 is more of the same, so I'm not going to bother with it).

 

 

For those of you who went to college in the same era that I did, I keep thinking of the word "guidance" now in the same way I used to think of the phrase, "Hi, Bob."

 

You're in luck

I take my 11:30 patient back to my office.

Dr. Grumpy: "Hi, Don, have a seat. How are you doing?"

Mr. Epazil: "Sorry if I'm in a rush, doc."

Dr. Grumpy: "Everything okay?"

Mr. Epazil: "Yeah, but I  have an appointment with Dr. Grumpy at 11:30. I think he's also in this building, but I can't remember where."

Pissy. Must. Die.

Me, Dr. Pissy, and our combined office staffs are having lunch with a drug rep.

 

Ms. Pharma: “That covers all the new info about Nomoshakin, so next time either of you sees a patient with refractory seizures, please keep Nomoshakin in mind. Any questions?” 

Dr. Grumpy: “No, thank you.” 

Ms: Rep: “Okay. Looks like we still have a few minutes, so let me tell you about Gramzap. This is our new, highly potent, highly absorbed, once-daily oral antibiotic. It has excellent coverage against many commonly encountered infections and…” 

Dr. Pissy: “Do you have samples?” 

Ms. Pharma: “Of course! Let me…” 

Dr. Pissy: “Please leave them for Dr. Grumpy. Gramzap sounds better than the weekly shots he gets at the free clinic."

Quote of the day

"I was in the ER last weekend for a seizure. They said my Kepdepatrol level was 4. Or maybe it was 8, actually, it could have been 14, or maybe 28. Whatever it was, it had either a 4 or an 8 in it, I'm not sure which. Does that help?"

Things seen in charts

 Here's this one, showing the hazards of cut & paste:

 

Next we have this bit of bullshit, which was, sadly, the entirety of the chart note and which told me nothing:

 

Apparently someone is hoping there's a CPT billing code for "vice versa:"

Next is another piece of crap someone pasted in. I'm willing to bet that the physician involved pastes this in at the end of pretty much every single note they write.

 

 

 

 

And, lastly:

Translation: just because I'm billing your insurance for treating a disease, doesn't mean you have that disease.

There are 11,000 neurologists in the U.S.

And a few weekends ago, due to a computer glitch, every one of them had an inbox that looked like this:

Voicemail theater

Message left at  6:55 a.m.

"Hi, thith ith Mike Thmith. I haf to canthel my appointment wif Dr. Grumpy for thith morning. I wath in a barfight lath night and loth thome teeth and have an emergenthy dental appointment. Thorry."

Message left at 7:00 a.m.

"Good morning, this is Dr. Perry O'Dontis. I'm sorry, but I'm going to have to cancel and reschedule my appointment with Dr. Grumpy for this morning. My partner is out of town, and one of his patients got into a barfight last night and had his teeth knocked out, so I need to work him in this morning."

Weekend on call

I've been called down to ER to see a fellow who suffered a stroke while at the local casino. His wife has just arrived.

Dr. Grumpy: "I'm glad you're here... his face is kind of drooping on this side. Is that normal for him?"

Mrs. Alteplase: "Let me see... He always has that."

Dr. Grumpy: "Okay. Do you know what medications he's on?"

Mrs. Alteplase: "No, but check his wallet. He always has that."

Dr. Grumpy: "Okay" (I start searching through the guy's pockets). "You know where he keeps it?"

Mrs. Alteplase: "No, but he always has that."

As I find and pull out the wallet a handgun - with the safety off - falls out of another pocket and lands on the floor with a loud THUNK. Me and 2 nurses freeze for a second, afraid it might go off.

Mrs. Alteplase: "He always has that."

Bathroom humor

A reader sent in this picture, where apparently an "out of order" sign just wasn't enough:

 

Of course, art imitates life, and vice versa:

Review of Systems

Dr. Grumpy: "Do you have any other health issues?"

Mr. Toss: "On January 14, 1999, I threw up in a Taco Bell bathroom, but other than that I've been fine."

Accuracy

Dr. Grumpy: "Have you had any surgeries, sir?"

Mr. Plumbum: "Yeah, I got shot, and they had to take out the bullet."

Dr. Grumpy: "Where did you got shot?"

Mr. Plumbum: "Korea."

Breaking the fourth wall

Actual CT scan report:

Thank you, M!

Abracadabra

Dr. Grumpy: "Have a seat, what can I do for you?"

Mrs. Anatidae: "My homeopath says his exam showed I have taurine in my brain, and referred me to you to take it out."

 

Pause

  

Dr. Grumpy: "Ma'am, everyone has taurine in their brain. It's critical for nerve function. It's in most organ systems."

 

Pause

 

Mrs. Anatidae: "So... you're telling me there isn't a surgery or something to take it out? He said there was."

Dr. Grumpy: "No. It's normal to have taurine in your brain. You need it to stay alive."

 

Pause

 

Mrs. Anatidae: "I'm sick of all the lies you regular doctors tell people like me to keep us sick so you can make money off our suffering!!!"

 

She stormed out and slammed the door.

 

Change

Since the twins are both at the same university, we bought them a car to share a few months back.

Yesterday we received a letter from the dealer's accounting department, saying they overcharged us in error, along with a check for the amount.

 

I am not making this up.

Write your own caption

This picture, I swear, is taken from the Disney website, showing a family enjoying the all-new MCU Avengers Campus at Disneyland.

If they're having fun, I can't imagine what the families who aren't enjoying it look like.

 

Meanwhile, up front

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

Ms. Young: "Hi, I was referred by Dr. Neverheardofhim, and he says you need to work me in RIGHT AWAY. Like, today. Now."

Mary: "We have nothing open today... I can do next Wednesday, at 2:30, or..."

Ms. Young: "I looked it up! On the internet it says you are legally obligated to get me in, since my doctor referred me urgently!"

Mary: "Uh, no. If you have an emergency you'll need to go to ER. We don't have any kind of relationship with Dr. Neverheardofhim. The soonest I get you in is Wednesday, though I can put you on a waiting list for..."

Ms. Young: "This is terrible that you're breaking the law like this! I'm going to call my cousin, who's a lawyer!"

She hung up

2 hours later

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

Ms. Young: "Hi, um, I was referred by Dr. Neverheardofhim, I called earlier, and I decided I'll take the Wednesday appointment."

Mary: "I'm sorry, but it's no longer available. We can see you Friday morning, at 8:00, or..."

Ms. Young: "You gave away my appointment? You can't do that!"

Mary: "You never made an appointment."

Ms. Young: "You offered it to me! That's the same thing! I looked it up! On the internet it says you are legally obligated to hold it for me."

Mary: "I'm not going to argue with you. Would you like the Friday morning slot?"

Ms. Young: "This is terrible that you're breaking the law like this! I'm going to call my cousin, who's a lawyer!"

She hung up 

 

1 hour later. 

 

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

Ms. Young: "Hi, um, I called earlier, I was referred by Dr. Neverheardofhim, can I take the Friday morning appointment? Is it still available?"

Mary: "It is, that's Friday morning at 8:00. Okay, what insurance do you have?"

Ms. Young: "Federal United Healthcare."

Mary: "Oh... I'm sorry, Dr. Grumpy isn't contracted with F-U Healthcare."

Ms. Young: "Dr. Neverheardofhim referred me! So you have to take it! I looked it up on the internet!"

Mary: "We don't take that plan, so you'll have to try their website to find a neurologist who does."

Ms. Young: "No, that's YOUR job! You need to find someone who takes my insurance, and have them work me in! It's the law! I looked it up on the internet! I'm going to call my cousin, who's a lawyer!"

Mary hung up

Deep thoughts

Mrs. Seegarp: "My headaches have been terrible the last few months, and I don't know why."

Dr. Grumpy: "Have you had more stress? Or does it seem the Perflukin has stopped working?"

Mrs. Seegarp: "I stopped Perflukin 3 months ago when the copay coupon expired."

Supermarket report

Hi, this is Frank.

I'm still working part-time at Local Grocery, carrying groceries out and pushing empty carts in.

At Local Grocery, and at pretty much all the other stores and malls around town, asshats of both sides STILL feel the need to cover someone else's property with stickers that say "Let's go, Brandon!" or "Dump Trump" or whatever. Usually they show up at night, and sometimes there's more than one layer where they try to cover the other side's stickers.

Can you people please stop this? This bullshit is only hurting me and my co-workers.

Because after you leave, thinking how clever you are for sticking the damn things all over cart corrals, lamp posts, "handicapped parking" signs, and even shopping carts that got missed at the closing sweep, we're the ones who have to scrape them off. So each day the morning shift has to send people out with chemicals and scrapers to deal with it, only to have some bozo put them back up the next night.

You think we like doing this at 6:00 a.m. in the Midwestern winter?

You're welcome to your opinion and your stickers. Cover your car, or your house, or your body with them. I don't care.

But all you're doing here is making more work for me, and a lot of other retail store drudges, from sea to shining sea.

The situation has gotten bad enough that now Local Grocery has hired a guy just to come in a few days a week and scrape them off the property, in addition to the extra cameras they've had to put up in the parking lot.

Those cameras aren't cheap. The guys who have to scrape off the stickers aren't volunteers. This stuff increases the store's overhead, and the same for stores, gas stations... wherever else you do this crap.

Which means that your prices are only going to go up. Certainly, this isn't a big driver of inflation in our world gone mad, but it contributes. And everyone has to pay for the asinine behavior of a few.

So grow up. Put them all over your house, car, and face if you want, but leave other people's property out if it.

Thank you.

Vacation memories

Recently my wife and I were going through photos from cruises we've taken, and I thought I'd share a few:

These buffet signs from the "Department of Obvious."

 

 

 

 

 

Perhaps a tad scarier was this item, which falls under "what do we do with all these leftover hot dogs?"

I went down to trivia, and realized I had no chance of winning a key chain:

For those unfamiliar with cruise ship trivia, the game is for bragging rights only. The prizes are generally cheap gift shop crap, like cruise-line themed key chains, beer koozies, golf tees, coasters, and pessaries. Except on Carnival, where it's a plastic trophy shaped like a ship.

One ship we were on had this large artwork in a staircase that, to me, looked like a dead body wrapped in a sheet:

 

Kind of like Kim Basinger being carried out toward the end of "Last Dance with Mary Jane":

One day the ship's activity guide listed an LGBTQ "delicious lunch feast" with camaraderie. Apparently, however, neither the feast nor camaraderie were to exceed 15 minutes:

 

 

 

This fire hazard is, admittedly, my own invention. It was an improvised set-up to keep my MacBook plugged into the only outlet I could find on the sun deck, using a power convertor and some empty cups to keep the whole thing from falling out.

Lastly, one night we were out strolling on deck, where the pool stand routinely had a cute towel animal on display. That evening we were kind of stunned to see it was, uh, something different.

"I dunno. Maybe they put Viagra in the laundry detergent?"

We were somewhat taken aback that the towel booth had taken an R-rated turn, until we continued walking and saw it from another angle:

 

That's all, folks!

Medical news headlines

Seen in a chart

 

Medicine cabinet

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

Mr. Clueless: "Hi, Dr. Grumpy has my wife on Fukitol, and it's either not helping, or it's making her sick. I'm not sure which."

Annie: "Okay, there's a big difference between those two things. Can you check with her, or just put her on the phone?"

Mr. Clueless: "She's at the casino with some friends, I can have her call you later?"

Annie: "Yeah, please have her..."

Mr. Clueless: "She's taking 2 and 1/2 pills twice each day."

Annie: "All right, it looks like she has both the 50mg and 200mg pill sizes from past scripts. Which size is she taking 2 and 1/2 of?"

Mr. Clueless: "I don't know. What difference does that make?"

Annie: "A lot. Just have her call me."

Mr. Clueless. "I will. Actually, maybe it's the Tidepod he has her on that's doing it."

Annie: "Dr. Grumpy doesn't have her on Tidepod. It's not in his field. Maybe one of her other doctors?"

Mr. Clueless: "Well, it's either Fukitol or Tidepod that she's taking, regardless of size, and it either isn't working or she needs a higher dose. Does that make sense... Actually, I'll just have her call you when she gets back, it will be in about an hour."

Annie: "That's probably for the best."

Best. Wikipedia. Page. Ever.

 

December 31, 2021

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

Mr. Scan: "Hi, doc, I need to talk to Annie, or whoever schedules tests for your practice."

Dr. Grumpy: "She's off this week, sir. My office message says we're closed until after New Years."

Mr. Scan: "Yeah, I heard that. Um, okay, maybe you can help me... Back in, uh, July, you sent me an order for an MRI. I have to get one every few years to follow up on my meningothingioma whatever, to make sure it isn't growing?"

Dr. Grumpy: "Yes."

Mr. Scan: "Anyway, I've been busy, and I need to get the scan done today, otherwise my deductible starts over tomorrow. So I've been calling MRI places, and none of them can get me in today, and I guess I need an insurance authorization for it, too, so I need you or Annie to get an authorization ASAP, and call one of these places and tell them I'm in a life threatening situation or something to get it done. Let me give you the numbers of the places I've called..."

Dr. Grumpy: "No, sir. Look, this isn't going to happen. Your MRI is not medically urgent, for one thing, and..."

Mr. Scan: "You don't know that! If the tumor is growing I could die from it tonight!!!"

Dr. Grumpy: "Well, it was ordered back in July, as you pointed out. You're the one who didn't call to set it up until the last day of the year. My staff is on vacation now."

Mr. Scan: "It's not like your note said 'please call before Christmas or we'll be closed,' did it?"

Dr. Grumpy: "I'm not going to argue with you sir. The bottom line is that the last day of the year is not the time to call to get a test done that you should have had 5 months ago. Just because you didn't think about this until today doesn't make it an emergency. Call back next week and we'll get it set up for you."

Mr. Scan: "You medical people are all such inconsiderate assholes."

Click

Shutting down for holidays

See you next year!

Bad Reputation

Dr. Grumpy: "How's your floral business doing?"

Mrs. Dixon: "I had to close down... The pandemic just wiped it out."

Dr. Grumpy: "I'm so sorry."

Mrs. Dixon: "Yeah, I mean, nobody saw that coming, but still... Anyway, in some ways it's been a blessing because it let me open a business that's closer to what I really wanted."

Dr. Grumpy: "What are you doing now?"

Mrs. Dixon: "I'm a psychic."

Reruns

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

Dr. Grumpy: "How are things now?"

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

Dr. Grumpy: "What about his fiancée?"

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

Round and round we go

Dr. Grumpy: "Has the medication helped?"

Mr. Son: "I think mom is doing okay with it, and the staff at the Alzheimer's home tell me..."

Mrs. Mother: "Wait... the place I'm living at is for Alzheimer's disease?"

Mr. Son: "Yes, mom."

Mrs. Mother: "Why do I live there, anyway?"

Modern life

Guy comes into office, Mary slides open her window.

Mary: "Hi, you have a 1:00 appointment? Okay. Can I make a copy of your insurance card? Thank you... Do you have a mask?"

Mr. Beijerinck: "No. I don't need one."

Mary: "Dr. Grumpy asks that all patients wear them. Let me give you one."

Mr. Beijerinck: "Little lady, the pandemic is over, if there ever was one. I ain't wearing a mask."

Mary: "Sir, because of the nature of his field, Dr. Grumpy sees a lot of patients on medications that suppress their immune systems, so for their protection we ask that everyone wear a mask when they go back to see him. Here's one you can wear during your visit."

Mr Beijerinck: "You want me to wear this?"

Mary: "Yes, just while you're here, please."

Mr. Beijerinck: "Okay, here."

He tears the mask into little pieces, tosses them through the window onto Mary's desk.

Mr. Beijerinck: "That's what I think of your bullshit rules. Now, honey, just go tell the doctor that I'm here for my appointment."

Mary: "Thank you for letting me know. Here's your insurance card back, I haven't copied it. I'll let the doctor know that I cancelled your appointment. Have a nice day."

Mary closes her window, pretends to answer her phone, and ignores him until he leaves.

1:47 a.m.

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

Mr. Lacune: "Hi, thish ish Dave Lacune, you shaw me at the hoshpital a few days ago, when I had a shtroke."

Dr. Grumpy: "Yes sir, are you okay? Your speech is pretty slurred, and I don't remember it having been affected by the stroke."

Mr. Lacune: "I'm fine. Look, you preshcribed Nomocva to me, to keep me from having another a shtroke, but I read about all itsh shide effectsh, and sho now I shtopped it and I'm afraid to take it."

Dr. Grumpy: "I'm kind of concerned you've had another stroke, sir. Your speech is pretty slurred."

Mr. Lacune: "Nah, my shpeech ish like thish because I've been doing tequila shotsh and shmoking weed all night because I'm anxioush."

Pause

Dr. Grumpy: "What are you so anxious about?"

Mr. Lacune: "Becaushe I shtopped Nomocva, sho now I'm worried I might have another shtroke."

Seen in a hospital chart

 

Second opinion

Dr. Grumpy: "Let's see... At your last visit I prescribed Flipazol. Did that help?"

Ms. Webb: "No, it didn't do anything."

Dr. Grumpy: "Were there any side effects?"

Ms. Webb: "There were a lot of them. It was terrible! I can't believe you prescribed it for me!"

Dr. Grumpy: "What happened?"

Ms. Webb: "Actually, I never even had it filled. I didn't like all the side effects I read about."

Dr. Grumpy: "Then why did you say it didn't help you?"

Ms. Webb: "A lady I met online told me it wouldn't."

Memories

In the early 1970's, my mom was found to have breast cancer. I was too young at the time to really understand it, and fortunately she's still around.

Anyway, she had a right mastectomy. At the time they waited about a year before they'd put in a breast implant, so during that time she used a prosthetic boob. She'd put it in her bra before leaving for work, and take it out when she got home.

Anyway, there was one day where she had a lot of errands to run, and when she got back was telling my dad how, everywhere she went, she got some strange looks. Nothing horrible, just people seemed surprised. She figured it was something she was wearing, or a large food stain on her blouse, or whatever.

My dad took her down the hall to their bathroom, where she'd left the fake breast lying on the counter.

Random pictures

 Okay, time to put up some stuff you guys have sent in.

First is this pizza place. I can only assume the owner isn't familiar with idioms. Either that or he's trying to keep the place empty.

 

Next, from the "nudge nudge, wink wink" department:

"Only $32? Is that at the same time?"

One reader wants to know why the Slurpee looks like the poop emoji.

 

Another says this beauty salon couldn't look more disreputable if it tried:

 

 

 

And lastly, a reader says he ordered a brisket sandwich with onions, and wished they'd abbreviated it differently.

Beep. Beep. Beep.

Dr. Grumpy: "Do you drive?"

Mr. Safety: "Oh, hell no. My seizures have been so unpredictable that I've given it up."

Dr. Grumpy: "Were they ever well-controlled?"

Mr. Safety: "They were good, but not great. It always seemed like one would occur when I'd just started to think they were controlled, and I'd have to stop driving again. I finally gave it up. It just wasn't safe for me, and I don't want to hurt anyone else. My friends and I all work at the same warehouse, so I just carpool with them and chip in gas money each week."

Dr. Grumpy: "That works out. What do you do over there?"

Mr. Safety: "I'm a forklift operator."

Blink

She was 19, here for migraines. She was nervous, had never been to a neurologist before, and her mother was along for emotional support.

We talked a bit, went over some treatment options. Nothing too costly. She worked full-time as a waitress, trying to save money so she could start college soon. We settled on nortriptyline and naproxen, and I began writing out scripts.

As I scribbled, I blinked.

Suddenly the scripts were gone. Instead of paper, I was typing in an online refill for generic sumatriptan… which a minute ago was brand-name, and she couldn’t afford it.

She was still there, across my desk, but she’d changed, too. She wasn’t a waitress anymore. She was working full time as a nurse, was married, and had two daughters. I remembered her having moved away to go to college, then nursing school, then coming back here. I recalled her telling me she'd gotten engaged. I’d treated her migraines through both pregnancies.

The nortriptyline hadn’t helped, and now she was on Aimovig, a drug I hadn’t imagined when she first came to me. In the time between then and now, besides the times she lived out-of-state, I recalled trying a handful of different medications over the years.

During my blink she’d developed a few gray hairs, wrinkles, and pounds from the stresses of daily life, jobs, raising a family, and making ends meet. I’m sure mine are worse.

This is also part of medicine, just as it is in everyday life. Over our careers we see college students mature into adults with jobs and families. We see parents become grandparents. The middle-aged become elderly.

We see people we’ve grown to care about die of things we can’t fix.

Being a doctor reflects the changes we see in our own lives as we travel around the sun. Our patients become a sort of extended family. We aren’t directly involved with their daily events, but we catch up on them here and there, and they see the same changes in us.

The drawings my kids did are still on my office walls, but haven’t been updated in a long time. Picking them up from the after-school program has been replaced by picking them up from the airport.

My hair has gradually thinned over time and become grayer.

The glasses I’ve worn since I was 8 have become bifocals.

All in a blink.

Mary's desk

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

Mrs. Frantic: "Hi, I have an urgent issue and need to get in RIGHT AWAY!"

Mary: "Hang on... Okay, the doctor can see you this afternoon, at 4:30... we also have an opening at 8:15 tomorrow morning, or..."

Mrs. Frantic: "Those won't work, um, I, uh, I'm actually out-of-town, on vacation, for another 2 weeks."

Pause

Mary: "Okay, when will you be back?"

Mrs. Frantic: "I don't have my work schedule here. Can I just call you after I get home?"

Seen in a chart

From an internist who apparently believes in "brevity is the soul of wit."

 

 

You  just know he billed this as a high-level visit, too.

Thank you, L!

Probably true

Dr. Grumpy: "Okay, then let's try increasing the dose of Flurpizol to 2 pills each night."

Mr. Martin: "That's what Annie had told me to do when I called last month, "

Dr. Grumpy: "I was wondering about that, because I see the phone call listed..."

Mr. Martin: "You're not angry at me, are you? I just wasn't sure."

Dr. Grumpy: "No, of course not. Let's just try the increase now and we'll see..."

Mr. Martin: "You're not going to tell Annie, are you? I don't want her to be angry at me, either."

Dr. Grumpy: "She won't be. Don't worry about it."

Mr. Martin: "Do you promise? Isn't she your boss?"