Inside Voices, Please

I'm sure this post is going to make my pharmacy readers cringe.

I went to my local pharmacy today for my Sarcasma refill (without it I'd have no patients, or friends, or staff).

Local Pharmacy was hopping. Very busy. Long line, only one poor pharmacist with dark circles under his eyes was working. Looked badly understaffed and overworked (I later found out they had 1 pharmacist and 2 techs call in sick today). And the pharmacist was frantically trying to keep from tearing his remaining hair out.

Finally there was only one elderly lady ahead of me, and I patiently waited my turn. Suddenly the cashier turned around and yelled "I need the pharmacist to counsel over here!" The bleary-eyed pharmacist actually was holding a phone receiver to each ear when this happened.

He paused for maybe 5 seconds, put one of the phones on hold, glanced at the computer screen next to him, and then yelled across the room: "Verapamil, uh, might make you constipated, or make you lightheaded!"

Thank heavens it was only for blood pressure pills.

Date Night

So on Saturday night Mrs. Grumpy and I actually found a (drumroll please) babysitter! Date Night! Woohoo!

So we went over to La Enchilada Grande. There was a large van in the parking lot, but I didn't pay much attention to it.

When we got inside the place was almost full. There was a large group at a big table in the center. We got a booth and began perusing menus and munching chips.

To my horror, I belatedly realized that the large group was a dinner field trip from La Casa deMentia, a local Alzheimer's home. And many of them were my patients.

Gotta love these people. They can't remember how to tie shoes, count money, or who their family members are, BUT THEY SURE AS SHIT CAN SPOT AND RECOGNIZE THEIR FREAKING NEUROLOGIST FROM ACROSS THE ROOM IN A BUSY RESTAURANT!!!

As a result our dinner was frequently interrupted by varying patients wandering over to say hi, help themselves to our chips, and/or ask directions to the bathroom. And since they have Alzheimer's disease they didn't recall doing so. One lady (with mismatched shoes and her blouse on inside-out) came over 3 times in one hour to tell me I looked familiar and to ask if we'd met before. One of them announced to her table (and the restaurant) that I was either her doctor or her grandson. Another asked me if I had any samples of "those memory pills, I forget what they're called".

We went elsewhere for dessert. Mrs. Grumpy noted the van's license plate for future reference if we see it in a parking lot again.

Get Your Butt Out of my Hospital, Loser

So I got called to come in to the hospital this Saturday morning. 21 year old woman who woke up this morning, completely paralyzed from the waist down. While driving in I turned over the possibilities: spinal card tumor, multiple sclerosis, big herniated disk, etc.

So I saw the patient, and as advertised she couldn't move either leg. There were some things about her story that didn't add up, but certainly she needed further work-up.

While I was out at the nurses station dictating a note she walked out of her room to ask where the smoking patio was.

As soon as she saw I was still there she ran back in and laid down on the bed.

What Does a Neurologist Do?

Many of you have written in to ask what I do, anyway.

Everyday a neurologist has to deal with many serious medical questions. My nurse Annie and I exchange email all day concerning critical patient problems and other important issues.

Here, for example, is an excerpt from an email that Annie and I recently exchanged on a patient who called in for urgent medical advice.

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Gee, Thanks for the Demo

I'm seeing a grizzled old cowboy this morning (boots, belt buckle, big ol' hat) for coordination problems, and am trying get an idea of what his limitations are.


Dr. Grumpy: "Do you have any problems combing your hair?"

Mr. Oldcowboy: (lifts up hat): "I ain't got no hair".

Dr. Grumpy: "Any trouble brushing your teeth?"

Mr. Oldcowboy: (pulls out dentures): "Ain't got those, either".

Feeling Special

I ordered some med samples (Axert) because Ortho-McNeil finally canned my incompetent drug rep. They came with a cover letter saying "Dear Dr. Grumpy, thank you for taking the time to order Axert samples, yadda yadda yadda."

Attached to the letter was an invoice of what was in the box.

Notice the circled item on the invoice: "Personalized Thank You Letter"

This just makes me feel SO appreciated.

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Early Morning at the Hospital

I was called in during the night to see a sweet old lady who'd fallen down and had a small brain bleed. When I was done examining her she asked me if I'd talk to her son "Big Hank" out in the waiting room. I said I'd be happy to.

"Big Hank" was the only person out there, and certainly was big. 6'5", maybe 280 pounds. Walrus moustache. In a lovely yellow & orange floral print dress. And a matching purse. Nylons. Black high-heel pumps.

Another Criminal Mastermind

Attention budding criminals:

When robbing a bank it IS NOT recommended that you leave your ID card with the teller, like this dude.

Healthy Living

I stopped on the way home for some tomatoes, and was in line at the checkout. The guy in front of me was a 30-something guy buying a crapload of vitamins and supplements.

Clerk: "You sure take a lot of vitamins."

Mr. Vitaminjunkie: "Yeah, cause, like, all the food today has, like, lot of unnatural stuff in it. So I take all these vitamins and only eat, like, natural and organics and stuff. That way I know I am going to stay healthy, and am like, not putting anything dangerous in my body."

Clerk: "Anything else for you today?"

Mr. Vitaminjunkie: (pointing behind counter) "Umm, yeah, like, give me 2 packs of Marlboros and a can of Skoal."

Doctors Behaving Badly

Dr. Dickweed is an internist upstairs from me. He's been there since I moved into the building over 10 years ago.

He's never referred to me. I'm polite, I've tried to talk to him in the elevator. When I started out 10 years ago I went by his office asking for referrals. He's coldly informed me that he doesn't trust, or refer to, physicians under 60 years old. Whatever. He's entitled to his opinion.

Anyway, my secretary interrupted me today to say that Dr. Dickweed was on the phone for me. This was a first, and I picked up the phone.

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

Dr. Dickweed: "Grumpy, this is Dickweed. I just want you to know that I'm out of Topamax samples, and one of my patients needs some. So I told her to come by your office to get some. Your staff doesn't need to schedule her for an appointment, and you don't need to see her. Just give her whatever Topamax samples you have."

Dr. Grumpy (somewhat taken aback by this kind request): "Dickweed, I'm out of Topamax samples."

Dr. Dickweed: "You young doctors are so fucking worthless." (click, hangs up).


The funny thing is that nobody has Topamax. They stopped giving out samples last Summer.

Einstein She Ain't

A new drug rep, Ms. Pharmafakeones, brought lunch to my office today, piling a bunch of sandwiches wrapped in white paper on the break room table.

Ms. Pharmafakeones was furious. She'd ordered 4 roast beef and 4 turkey sandwiches, and was angry because she'd asked the deli to label them so people could tell what kind of sandwich it was without opening it.

Instead (according to her), the deli had only written "their own codes" on the wrappers, so she wasn't sure which were which.

My staff noticed that 4 of the wrappers said "RB", and the other 4 said "Gobbler".

Ms. Pharmafakeones was amazed at how my staff were able to figure this out.

Smokin' Deal, Dude!

I was looking for a new camera a few weeks ago, and noticed this on Amazon. Check out the remarkable savings Amazon offers over the list price.

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It's The Little Old Lady from Pasadena

Last night, on my way home from the hospital, Mrs. Grumpy called and asked me to stop for some tomatoes (don't get me started). So I pulled into Local Grocery.

Inside Local Grocery, one aisle looked like a war zone. A large cardboard display had fallen over and was torn in half. Cans were everywhere, like a bulldozer had driven through a display. There were a few potted plants from a nearby gardening display that were lying on their sides, with soil spilling out. A small army of teenagers with push brooms were working on the mess.

But, since I was in hurry, I grabbed my tomatoes and left.

I'd forgotten about it until today. My 10:30 is a sweet old lady with serious balance problems, who recently got a motorized scooter. So I asked her how she's been doing with learning to drive it.

"I've been doing fine. Or at least I thought I was. I keep forgetting how to stop it, and last night I was going down the aisle at Local Grocery, when I tried to slow down and swerve around this huge display of cans........"

Okay, So I'm Cheap

If I ever catch the person who super-glued a dime to the floor of the doctor's lounge sometime last night, I'M GOING TO KICK YOUR BUTT!!!