Hello? Hello? Who am I?

I got dragged into the hospital this morning to see a guy for Alzheimer's disease. He was in one of the 2-patient rooms, with them separated by a curtain. And both of the guys were old and demented.

So while I"m talking to the guy in bed 1, he moves his arm, and immediately his IV pump says "downstream occlusion" and starts beeping annoyingly, a series of repeating chimes "beep-beep-boop-bop-bop".

So the guy in bed 2 thinks it's his phone ringing, and starts answering it! "Hello! Hello! Who is this?" slams it down. "Those damn kids"

And it keeps going! Every 30 seconds the pump chimes, and the other guy does the same thing "Hello! Hello!" I was in the room for 15 minutes, and he answered the phone 12 times.

It was still going on when I left the room.

Hmmmmmmm............

So this morning I had a couple in their late 20’s in the office. I'm working-up Mr. Youngcouple for some oddball symptoms, and his labs turned up a positive syphilis test.

So we discussed this at length. He was horrified. Kept insisting “there’s no way I can have syphilis! Ever! My wife is the only person I’ve ever been with!”

Once I said “syphilis” Mrs. Youngcouple stopped making eye contact with either of us. She just became very fixated on playing Tetris on her cell phone and occasionally staring intently at something on the floor.

You're a Freakin' Bozo, Sir.

This afternoon I'm seeing this guy. He has cancer, and is getting chemotherapy with a drug known to cause headaches.

So he's going into tearful detail on how he gets his chemotherapy on Wednesdays, and then on the Thursdays after he has a horrible headache that sends him to ER.

I reviewed different options (besides stopping cancer treatment): medications to get rid of his headaches, medications to prevent his headaches, etc. He then asks me this:

"Doctor, I'm not sure I want to take more medications. Wouldn't it be easier to just move my chemotherapy to Mondays, instead?"

Torturing Your Child

So, Grumpy fans, a catalog of various medical supplies showed up in today's mail (addressed to "Physician Occupant" no less).

It included this remarkable device. According to the caption, the purpose of this thing is to "comfortably help children sleep" who have breathing problems when lying on their backs.

I don't know about you guys, but I can't see how any of my kids would "comfortably" lie face down in this thing for more then, say, 5 seconds, unless I used duct tape to hold them there.

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Why are my prescriptions so expensive?

There are a lot reasons drugs are so damn expensive, gang. I'm sure research & development are most of it, but some of it is because of sheer stupidity and waste on the pharmaceutical company's part.

Case in point: If you remember, I spent a February weekend in LA at a drug company meeting, and they asked me to bill them for my expenses. So I sent them my receipt ($32) for airport parking.

I got my $32 check today. It was sent by FedEx priority overnight delivery from Philadelphia.

The cost of sending me the check was $10.55.

For the record, I didn't ask for emergency delivery. I would have been happy with a 42 cent stamp.

More Stupidity

Ok, gang, I just had to post this link. This is amazing. A woman who called 911 because she couldn't figure out how to open her own car FROM THE INSIDE!!!

Check it out!

Ride 'em Cowboy!

One of my back pain patients came in today. Showed me the new massage device he's been using for his pain, with great success.

It was HUGE. The size of 2 car batteries side-by-side. And heavy. And when he plugged it in and turned it on it sounded like a freaking lawnmower.

I asked him where he got it, and he said he saw it being used at this year's Arabian horse show. It's made to massage horses. He bought it from a trainer.

It actually had a label on it that said "NOT FOR HUMAN USE".

Idiots Among Us

I got the greatest call from a pharmacist today. Here's the story:

On September 15, 2004 I saw a lady for low back pain and gave her a script for Percocet.

For whatever reason, she never had the script filled, just shoved it in a drawer at home. She never followed up with me.

Yesterday she apparently found the script buried in the drawer, and decided she should get it filled. She figured (correctly) that the pharmacy wouldn't fill anything that was written 5 years ago.

So she changed the date on it to September 15, 2009, and took it to Walgreens.

The pharmacist who called me was laughing so hard he was crying.

Say that again?

This is a gem. From a new patient today, that I was getting some family background on:

Dr. Grumpy: "Any history of miscarriages in your family?"

Mrs. Notsobright: "My Mom had one, with me."

No, You Idiots. I Treat Dead Patients, Too.

Check this out, Grumpyites. This is a form I have to fill out every few months for patients to continue receiving a drug called Tysabri.

I direct you to question #1: Is the patient still under your care?

IF I answer "yes" to that question, THEN (in question #2) I'm asked if the patient is alive!

How much do you think they paid the bozo who wrote this form?

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True Love in the ICU

Hi, grumpy fans. Your hero was on call this weekend.

This morning I was called to evaluate a 23 year-old female who was found
floating face down in her pool. Probable suicide attempt, with brain damage.

While I was writing my chart note a nurse came over to tell me that the
patient's fiancé was on the phone, and wanted to talk to a doctor about
what was going on. I picked up the phone and had the following
conversation:

Dr. Grumpy: "Hello?."

Mr. Fiancé: "Yeah, are you the doctor taking care of my fiancé, Jane Doe?"

Dr. Grumpy: "Yes sir, what can I do for you?"

Mr. Fiancé: "Are her car keys there? 'Cause it's my car, and I need it back."

Dr. Grumpy: (astounded) "No sir, there aren't any car keys here."

Mr. Fiancé: "Well, did she leave a note saying where the car keys were, or where she left my car parked? I need it, because I have stuff to do today."

Dr. Grumpy: "No, sir, nothing like that"

Mr. Fiancé: "Well, you're no help to me" (hung up the phone).

You people drive me nuts!

So the Friday before leaving on the cruise I saw this guy for back pain. Since I manage my own patients no matter where I am, I had to deal with him all week on my trip.

He wanted an urgent MRI (his request, I didn't feel it was medically urgent). So the weekend after his Friday appointment he called my closed office 5 times to see if we'd scheduled it yet (sorry, sir, your crappy HMO hasn't opened their authorization department on a weekend just to accommodate you). But on Monday, my nurse, who can work miracles, somehow got an authorization expedited just to shut him up.

So we got the MRI mid-week. I personally called him Friday afternoon from the cruise to go over his benign results. He demanded that I do "Something! Anything! Just fix me!" (for the record, sir, doing so is beyond the skills of the best psychiatrists). So I told him I'd order physical therapy.

So this past weekend, apparently forgetting that Crappy HMO, Inc., isn't open on weekends, he called 3 times to see if his physical therapy had been set up yet.

My secretary called him Monday morning to schedule his physical therapy. He told her that he'd decided at the last minute to go on a 3 week trip to visit some old college buddies in Idaho, and would call us when he got back.

Back to the Salt Mines

So within 48 hours of me getting home, I got dragged in to the hospital. One of my office patients had a stroke on a weekend. Can you believe the nerve? They should schedule this sort of thing in advance.

Anyway, I wandered into the doctor's lounge, where the TV was off. This is a remarkable event. The TV in there is ALWAYS on, usually turned to CNN or ESPN or MSNBC.

So the giant TV is quiet, with a little sign taped to it that says "The cable box will be fixed on 3-23."

In spite of this, there were 3 (count 'em! 3!) docs sprawled across chairs in front of the electronic deity, just as if it were on! Staring at the blank screen, and occasionally mumbling to each other how they wish it would be fixed today!

Does this seem odd to anyone else out there?

Cruising with Dr. Grumpy, #6

(It’s Spring Break! We are taking advantage of recession rates to take our brood on a Mexican cruise. So you guys can now enjoy a week of relatively medical-free posts, with me blogging from the ship).

Friday

At sea, going in slow loops back toward LA. Today was our last day on the S.S. Buffet.

After breakfast I entered a trivia contest (I won). It was run by the activities director, who kept misplacing things and forgetting questions. At one point I jokingly said, "I'm a neurologist, let me give you my card", and the crowd laughed. After the contest she cornered me. Said she had epilepsy, wanted to know what I thought of Depakote. That will teach me to keep my mouth shut.

You know it's time to go home because the amount of water you displace getting into the hot tub is a lot more than it was on day 1 of the trip. And those hot college babes in tight thong bikinis? After 7 days of nonstop meals they don't fit into their bikinis very well, and are now the size of shipping hazards.

A phenomenon you see on the last day are these forlorn 16 year old couples wandering around, holding hands, or staring into each other's eyes over a Diet Coke on the Promenade deck. They never knew each other until a few days ago, and now they feel like here, on a cruise ship, they've met their soulmate, and can't bear the thought of going back home to their respective home towns of Slotmachine, Nevada and Los Taquitos, California. And in 2 weeks they'll have a vague memory of each other, "oh yeah, this is a picture of whathisname, that guy I met on the cruise"

Why does every issue of the daily newsletter "Cruiseline Capers" list the captain's name on it? It's not like it should be changing from day to day. Is this to reassure you that there was no mutiny overnight? If there was, would they put the new captain's name on the newsletter ?

After a round of mini-golf Marie and I went up front to look over the bow. Occasionally you'd see a dolphin leap up, or rarely a whale surface and blow air. She, unfortunately, has now decided that EVERY whitecap on the ocean is a dolphin or whale. So when she sees whitecaps (which is often) she begins screaming that she sees a whale or dolphin. Mrs. Grumpy and I have learned to ignore her, but when she does this so many other passengers drop what they are doing and rush over to look that you expect the ship to tilt.

To wrap up our last day, we went to a comedy show in the main theater, where they were just finishing a round of Bingo. They were trying to get 5 numbers in a row. We all know how to play bingo. Apparently, it's simplicity is beyond the IQ of a lot. We would see people jump up and yell "Bingo" and start screaming wildly. So the person in charge would wander back to find they only had 2 or 3 out of 5 numbers in a row. This actually happened quite often. How stupid can you be? Or were they hoping the director would say, "hey, you only got 3 of the 5 numbers, but since you were willing to jump up and make an ass out of yourself we'll give it to you, anyway."

The day concluded with an excellent dinner, but by this point we were getting tired of food. You find yourself looking at the menu of prime rib and lobster and want to ask for a big bowl of Kellogg's Colon-Blow cereal instead.

So, from somewhere off Baja Calfornia: Merry Spring Break to all, and to all a good night.