Monday, February 8, 2010

2 tomatoes, pickles, hamburger buns, lettuce, and a dessert

Mr. Lumbarpain: "Oh, hi Dr. G! How ya doin'?"

Dr. Grumpy: "Oh, uh, fine, um, I didn't recognize you when I got in line."

Mr. Lumbarpain: "Yeah, I'm workin' at Local Grocery now. Ya got a Shopper's Card?"

Dr. Grumpy: "Here, thanks."

Mr. Lumbarpain: "Lemme ring this up. Looks like you're havin' burgers. Paper or plastic?"

Dr. Grumpy: "Yeah, I guess. Paper."

Mr. Lumbarpain: "Ya know, my back is still killin' me, and it goes down my right leg."

Dr. Grumpy: "Oh, why don't you call Mary and..."

Mr. Lumbarpain: "Some days it goes around into my groin, too. Got any coupons?"

Dr. Grumpy: "No..."

(Lady in line behind me grabs her basket and runs for her life).

Mr. Lumbarpain: "Sometimes it burns, ya know, like I have a rash going down my butt and the leg. That'll be $18.73. Credit or debit?"

Dr. Grumpy: "Credit."

Mr. Lumbarpain: "Can you sign here? And then when I look, there's no rash, it just feels that way."

Dr. Grumpy: "You should call Mary tomorrow and..."

Mr. Lumberpain: "Nice seein' ya, doc. Hi, lady. Ya got a Shopper's card?"

Office buffet, part 2

For those of you who survived the dreaded holiday food onslaught, comes the sequel:

The "dump your Superbowl party leftovers in the office break room" buffet.

Featuring: deviled eggs, soggy nachos, hot wings, pizza, a variety of chips, bean dip, spinach dip, artichoke dip, cheese dip, the remains of a vegetable platter, pie, cookies, sliced turkey, mini-wieners, rolls, Miracle Whip, crackers, brownies, 1/4 of a cheese log, swedish meatballs, rolls, a tupperware thing full of barbecued something, and a cookie that the staff calls "Hillbilly Crack".

I'm gonna hit the Protonix samples.

Monday morning, 12:45 a.m.

Tap tap tap

Dr. Grumpy: "Hmmm."

Tap tap tap

Dr. Grumpy: "Mmm... Frank, what do you need?"

Frank: "Dad, can I turn on your lamp? I want to show you something."

Dr. Grumpy: "It's the middle of night. What do you..."

CLICK! AAAAAHHHHH! BRIGHT LIGHT!

Dr. Grumpy: "Holy crap, Frank! WHAT THE HELL HAPPENED TO YOUR HEAD?!!"

Frank: "I gave myself a haircut!"

Dr. Grumpy: "Um, yes. Why on Earth did you do that?"

Frank: "I couldn't sleep."

Sunday, February 7, 2010

Sunday, 1:18 p.m.

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

Mr. Pigskin: "Yeah, um, you see my wife for seizures, and she's had 3 today. Big ones, I mean, she bit her tongue a lot, and now I can't get her to wake up. She's breathing and all, but..."

Dr. Grumpy: "That sounds serious. You need to call 911, or take her to ER immediately."

Mr. Pigskin: "Really? Um... Okay..."

Dr. Grumpy: "Have them take her to Local Hospital, and I'll see her there, and they have all her records."

Mr. Pigskin: "How long will this take? I mean, the Superbowl is today, and..."

Dr. Grumpy: "This is very serious! You need to get her to ER NOW!"

Mr. Pigskin: "Do they have TV's in the ER there?"

Dr. Grumpy: "Yes!"

Mr. Pigskin: "What do I tell my buddies? They were gonna come over, and I mean, she's starting to wake up, and oh, she's seizing again."

Dr. Grumpy: "You stay right there. I have your address, and I'm calling 911 now for you."

Mr. Pigskin: "Cool, thanks, doc. That's a lot of help. Hey do you want to come over and watch the game?"

May I take your order?

So last night we went to La Enchilada Grande for dinner.

I ordered the enchilada platter, and perky waitress says "That's a good choice. My dad over there just ordered it, too."

Whatever. Our dinner goes on. A few minutes later I hear a lady across the aisle order a taco salad, and Ms. Perky says "That's a good choice. My dad over there just ordered it, too."

And a few minutes later a new group was seated in the booth behind us. A guy ordered the Grande Chimichanga, and Ms. Perky, of course, says "That's a good choice. My dad over there just ordered it, too."

Now, granted I wasn't really watching where she was pointing with "over there", but I can only come up with 3 options:

1. She's full of shit.

2. Her Dad has a huge appetite.

3. Her mother was remarkably promiscuous, and by an amazing coincidence all of this girl's potential dads felt like Mexican food last night.

Saturday, February 6, 2010

My readers write

Patients drive doctors nuts, and doctors drive patients nuts.

But in all of that, sometimes we overlook the stupidity that can surround a visit to the doctor, where neither side is at fault.

So I'd like to think my reader Cheryl for submitting this picture.

Her husband went to see his cardiologist. After the appointment he found that the helpful parking garage staff had filled in a pothole behind his truck, and roped it off.


Food ads you don't see everyday

This was in a "healthy eating" type magazine that showed up in the office one day.


Friday, February 5, 2010

Quotable patients

"I was dizzy, but the pills made me undizzy, and I've been undizzy since."

These are not negotiations

I'm here to try and help you, people. You may not believe that, but it's true.

I'm not ordering the tests for MY benefit. They are so I can figure out what's wrong with you, and fix it.

Personally, I don't give a crap if you don't have them. That's your business. You came to me for my advice, and I'm giving it.

Don't try to negotiate with me on this. They are entirely for your benefit, not mine.

Therefore, comments like the following WILL NOT get you anywhere in Dr. Grumpy's world:

1. "I'll have the brain MRI, but ONLY if you'll waive my co-pay."

2. "Okay, I'll do the CT scan, but you have to pay whatever my insurance won't cover."

3. "If the labs are that important I'll get them, on the condition that you order some for my husband, too, because he's due and doesn't want to see his internist."

4. "You can do the test, but only if the MRI place agrees not to charge for it."

And my personal favorite:

5. "I'll only let you do the tests if you'll double my monthly Percocet."

Thursday, February 4, 2010

Hey, who doesn't?

Dr. Grumpy: "Any other medical issues?"

Mr. Medical: "I have blood pressure."

Dr. Grumpy: High or low blood pressure?'

Mr. Medical: "No, just blood pressure."

Thank heavens!

When you're waiting for your 8:00 new patient, and out the window you see 2 cops escorting a HUGE guy in an orange prison jumpsuit, with cuffs on his hands and wrists, into your office building...

It's a great sense of relief to see them take him into someone else's office.

Wednesday, February 3, 2010

Attention patients!

If your ringtone is a fart, please silence it before entering my office.

If it wasn't your ringtone, and you only said that to cover yourself, please go change your underwear.

Beats my hot tub articles

Mr. Shakes: "Is there anything new out there, doc? I try to keep up on changes in the field."

Dr. Grumpy: "Oh, what do you read?"

Mr. Shakes: "The obituaries."

Um, I, uh, my answer is...

I was doing an internet medical study this morning. It featured this question:


You are a (please check only one):

A. Neurologist
B. Cardiologist
C. Other medical practitioner
D. Male
E. Female

February 3, 1959

(briefly going off my usual topics)

The day the music died.

On this day in 1959, a plane crash claimed the lives of singers Buddy Holly, Ritchie Valens, JP "The Big Bopper" Richardson, and pilot Roger Peterson).

Don McLean, in one of the greatest songs ever written, summarized the tragedy, and in a truly remarkable collection of words told the story of American music from the 1950's to 1969.


A long, long time ago...
I can still remember
How that music used to make me smile.
And I knew if I had my chance
That I could make those people dance
And maybe they'd be happy for a while.

But February made me shiver
With every paper I'd deliver.
Bad news on the doorstep;
I couldn't take one more step.

I can't remember if I cried
When I read about his widowed bride,
But something touched me deep inside
The day the music died.

So bye-bye, Miss American Pie.
Drove my Chevy to the levee,
But the levee was dry.
And good old boys were drinking whiskey and rye
Singing, "this'll be the day that I die.
"This'll be the day that I die."

Did you write the Book of Love?
And do you have faith in God above,
If the Bible tells you so?
And do you believe in rock and roll,
Can music save your mortal soul,
And can you teach me how to dance real slow?

Well, I know that you're in love with him
`Cause I saw you dancin' in the gym.
You both kicked off your shoes.
Man, I dig those rhythm and blues.

I was a lonely teenage broncin' buck
With a pink carnation and a pickup truck,
But I knew I was out of luck
The day the music died.

I started singin',
Bye-bye, Miss American Pie.
Drove my Chevy to the levee,
But the levee was dry.
And good old boys were drinkin' whiskey and rye
Singin', "this'll be the day that I die.
This'll be the day that I die"

Now for ten years we've been on our own
And moss grows fat on a rolling stone,
But that's not how it used to be.
When the Jester sang for the King and Queen,
In a coat he borrowed from James Dean
In a voice that came from you and me,

Oh, and while the King was looking down,
The Jester stole his thorny crown.
The courtroom was adjourned;
No verdict was returned.
And while Lennon read a book on Marx,
The Quartet practiced in the park,
And we sang dirges in the dark
The day the music died.

We were singing,
Bye-bye, Miss American Pie.
Drove my chevy to the levee,
But the levee was dry.
And good old boys were drinkin' whiskey and rye
Singin', "this'll be the day that I die.
This'll be the day that I die."

Helter Skelter in a summer swelter.
The Byrds flew off with a fallout shelter,
Eight miles high and falling fast.
It landed foul on the grass.
The players tried for a forward pass,
With the Jester on the sidelines in a cast.

Now the half-time air was sweet perfume
While the Sergeants played a marching tune.
We all got up to dance,
Oh, but we never got the chance!
`cause the players tried to take the field;
The marching band refused to yield.
Do you recall what was revealed
The day the music died?

We started singing,
"bye-bye, Miss American Pie."
Drove my Chevy to the levee,
But the levee was dry.
And good old boys were drinkin' whiskey and rye
Singin', "this'll be the day that I die.
"This'll be the day that I die."

Oh, and there we were all in one place,
A generation lost in space
With no time left to start again.
So come on: jack be nimble, jack be quick!
Jack Flash sat on a candlestick
'Cause fire is the devil's only friend.

Oh, and as I watched him on the stage
My hands were clenched in fists of rage.
No angel born in hell
Could break that Satan's spell.

And as the flames climbed high into the night
To light the sacrificial rite,
I saw Satan laughing with delight
The day the music died

He was singing,
"Bye-bye, Miss American Pie."
Drove my Chevy to the levee,
But the levee was dry.
And good old boys were drinkin' whiskey and rye
Singin', "this'll be the day that I die.
"This'll be the day that I die."

I met a girl who sang the blues
And I asked her for some happy news,
But she just smiled and turned away.
I went down to the sacred store
Where I'd heard the music years before,
But the man there said the music wouldn't play.

And in the streets the children screamed,
The lovers cried, and the poets dreamed.
But not a word was spoken;
The church bells all were broken.
And the three men I admire most:
The father, son, and the holy ghost,
They caught the last train for the coast
The day the music died.

And they were singing,
"Bye-bye, Miss American pie."
Drove my Chevy to the levee,
But the levee was dry.
And good old boys were drinkin' whiskey and rye
Singin', "this'll be the day that I die.
"this'll be the day that I die."

They were singing,
"bye-bye, Miss American Pie."
Drove my Chevy to the levee,
But the levee was dry.
And good old boys were drinkin' whiskey and rye
Singin', "this'll be the day that I die."

Tuesday, February 2, 2010

Mary's Desk, February 2, 2010

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

Ms. Doofus: "Yes, I need to make an appointment to see Dr. Grumpy."

Mary: "Okay, let's see... We can see you tomorrow afternoon at 3:00?"

Ms. Doofus: "That won't work. I need mornings, before 9:00. I do a day-care center out of my house, and have about 20 kids until 6:00 p.m."

Mary: "Hmm, our mornings are filled until next week, how about next Monday at 8:00 a.m.?"

Ms. Doofus: "I'd really like to get in this week."

Mary: "I'm sorry, but afternoons are all we have left this week."

Ms. Doofus: "Well, I guess I can do tomorrow. There's only 20 kids, can I bring them and have your staff watch them for me?"

Reasons to avoid cheap bras

Dr. Grumpy: "How did the car accident happen?"

Mr. Smash: "Well, this lady in front of me had this huge rack. I think she used it for towing stuff. And I guess something broke, and her rack flew off and smashed my front end. It was one of the biggest racks I've ever seen. I mean, it must have hit 2 or 3 other cars too before it stopped, and people were swerving, and everyone was watching her rack lying in the middle of the road. And she didn't care if she'd hurt anyone else. All she kept saying was that we'd ruined her rack, and that she'd paid a lot of money for it, too."

And the award for best actress in a hospital gown goes to...

This morning I did a hospital consult on a psychiatric patient with pseudo-seizures.

While I was talking to her she suddenly yelled the dreaded "Oh no! You're making me have a seizure! Here it comes!"

This was followed by a an acting job with yelling, thrashing, and moaning that looked more like Meg Ryan's famous deli scene from "When Harry Met Sally" then any kind of epilepsy I've ever seen.

"Oh God! Oh my God! Oh my God! I'm having a seizure! I'm seizing! Oh! Oh! Oh!"

After it was over she opened her eyes and said "Did you think I was having a seizure?"

I thought about telling her what I really thought she was having, but decided to keep my mouth shut.

Monday, February 1, 2010

Vocabulary homework

Dr. Grumpy: "Okay, next word, what does 'buffeted' mean?"

Craig: "Um, to eat a lot? Like at the chinese place with all the food you want?"

Sometimes it's fun

Seeing a sweet old lady this afternoon, named Elizabeth.


Dr. Grumpy: "Do you go by Elizabeth? Or do you have a nickname you prefer?"

Elizabeth: "Just Elizabeth. My parents were very poor, and couldn't afford a nickname."

A study of ONE FREAKING PATIENT!

I'd like to thank my reader, Dr. T., for submitting this gem. It may be 20 years old, but hey, people still get the hiccups.

And again, it's from Haifa, Israel. For reasons that remain mysterious, an unusual proportion of oddball research seems to be from there. A review of my past posts will show several Haifan studies.


Termination of intractable hiccups with digital rectal massage.

J Intern Med. 1990 Feb;227(2):145-6

Odeh M, Bassan H, Oliven A.
Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel.

A 60-year-old man with acute pancreatitis developed persistent hiccups after insertion of a nasogastric tube. Removal of the latter did not terminate the hiccups which had also been treated with different drugs, and several manoeuvres were attempted, but with no success. Digital rectal massage was then performed resulting in abrupt cessation of the hiccups. Recurrence of the hiccups occurred several hours later, and again, they were terminated immediately with digital rectal massage. No other recurrences were observed. This is the second reported case associating cessation of intractable hiccups with digital rectal massage. We suggest that this manoeuvre should be considered in cases of intractable hiccups before proceeding with pharmacological agents.


PMID: 2299306 [PubMed - indexed for MEDLINE]

More Allergies

Dr. Grumpy: "Are you allergic to any medications?"

Mr. Sure: "Naprosyn."

Dr. Grumpy: "What happens when you take Naprosyn?"

Mr. Sure: "My armpit deodorant doesn't last as long as it should."

How does pointless research get published?

In light of my many posts on obvious and/or stupid research, quite a few of you have written in with that question.

There are several answers, but the most common one is busy work. And I am my own best example.

I am not an academic/research person. I have nothing against those who are, it's just not my thing. One of my career goals was to die unpublished. I didn't ever want my name in any journal, anywhere.

But when I was doing my fellowship, the chairman was of the opinion that it was critically important that everyone get published at some point, regardless of the quality of the research involved. So he came up with an absolutely bullshit project for me. And I was faced with the options of doing it or failing the fellowship.

So I did the project. It was remarkably stupid and pointless. it consisted of me reading through MOUNTAINS of old charts, going back several years, and making notes. For the record, a lot of BS research is done this way. Some poor sucker in training is forced to tediously analyze endless piles of old charts or videos or patient forms or something, to come up with worthless information, under the threat of failing out of their program.

Let's face it. You can get pointless data out of anything: "Our chart review found that people who saw the original release of The Wizard of Oz in 1939 were more likely to have Alzheimer's disease in 2009 then those who'd seen the original release of Star Wars in 1977. This suggests an unidentified risk factor for dementia in seeing MGM films vs. those made by 20th Century Fox."

And these studies are generally cheap to do, because you're already paying the salary of the resident or fellow involved (even cheaper for med students, since they work for brownie points).

And there's always a crappy journal out there, trying to get advertising dollars and willing to publish anything to get readers.

So I found some meaningless data, and at a weekly division meeting I presented it. There were 4 attending physicians and 2 fellows in my subspecialty at the time. 3 of the attendings, and both of the fellows (including me) agreed the paper and it's findings were meaningless drivel.

Unfortunately, the only person who disagreed was the chairman. And since he was editor at the time of some desperate medical journal, he got my paper published there.

To make matters worse, he then got me a poster spot at the annual neurology meeting that year. So I had to go to this meeting, set up a poster with my worthless data on it and then STAND BY IT wearing a badge that identified me as the author.

So for the required 2 hours I stood there, trying to smile at all the big league academics going by. Most looked at my poster and politely didn't say a word. A few gave me sympathetic looks. 3 made comments about how worthless it was (I silently agreed). Only one said something kind.

I left the poster hanging in the meeting hall. I think I was the only person who didn't take theirs home. I assume it's in a landfill by now.

My shitty article got published a few months later, and several intelligent neurologists (who I assume were reading in a hot tub) found my paper to be such absolute garbage that they felt the need to write to the journal to complain. And the journal editor, my chairman, forwarded the letters to me to write a rebuttal.

How do you defend the indefensible? Hell, I agreed with them.

But by this point I'd completed the fellowship, and was an attending physician. And I didn't care. So I just tossed his requests in the trash.

So my sole contribution to the medical literature is out there. Fortunately, as the years go by, it will continually be buried under newer (though equally worthless) data.

And that's where at least some crappy research comes from. And I suspect most of it has similar origins. Some poor sap who's under pressure to publish something, anything, regardless of how stupid or obvious it is, or people trying to pad their resume, or someone with way too much time on their hands and absolutely no life (if you're in the last category, get a dog. Or join Facebook. Or do ANYTHING to waste your time in a more useful way), and crappy journals willing to publish anything.

And that's the way it is.

Sunday, January 31, 2010

Sunday hot tub reading

Okay, I polished off a few more journals to help keep up-to-date this afternoon, and have learned that:


People who use excessive amounts of salt have increased risks of stroke and heart disease (WOW! I've never heard that one before!). British Medical Journal, November 24, 2009.

Excedrin Migraine is effective for some patients with migraines (when compared to placebo), but not for others. Paper presented at the 14th Congress of the International Headache Society.

People who have severe migraines on workdays are more likely to miss work due to migraines, than people who don't have migraines during those times. Another paper presented at the 14th Congress of the International Headache Society.

Dr. Grumpy's Rules, #1024

No good will EVER come out of returning a Sunday morning message that begins with:

"Yeah, I have an appointment with Dr. Grumpy this morning, and your office building is all locked up."

Saturday, January 30, 2010

Breaking Medical News

I was relaxing in the hot tub today, catching up on cutting edge medical literature.

I learned that:

Patients on sedating drugs have a higher risk of falling than those not taking sedatives.

Patients with imbalance from inner ear problems are more likely to fall than those without balance problems.

(Archives of Internal Medicine, May 25, 2009)


I also learned:

People with a stroke, and poor blood flow to the area of brain involved, are more likely to have another stroke then people with normal blood flow to that area.

(Brain, April, 2009)

My readers write

This photo was submitted by reader Francine, who says she took it in a hospital ER.

For all the advice painted on the top and bottom of the machine, I have to say I don't see anything remotely healthy in there.


(click to enlarge)




And thank you Francine for sending this in!

Friday, January 29, 2010

Friday afternoon insanity

Dr. Grumpy: "Let me fill out an MRI form... Are you claustrophobic?"

Ms. Bright: "No. My period started yesterday."

Mystery solved

Last night I was at a dinner meeting for a research company. These things are always held at some swanky overpriced steakhouse.

Dr. Duffel is a local neurologist who drags around the biggest damn purse in the world. It's HUGE, and goes everywhere with her. For years many of us have wondered what's in it: a complete set of every neurology journal ever written? Jimmy Hoffa? the Bermuda Triangle?

So last night she came in late to the dinner, and sat down next to me. She put el monstro humungo purse on the floor next to me, so I had to move over a bit.

The meeting dragged on. One slide after another. The occasional cell phone ringing. The speaker droning. Food courses.

At some point I wandered out to stretch and empty myself of biologically-filtered Diet Coke. When I came back and sat down I stepped in a puddle on the floor. I figured someone must have spilled water or something while I was out of the room, and refocused my attention on the speaker.

A minute later a waitress came by to refill my Diet Coke, and stumbled over the giant purse.

And the purse started barking.

The waitress screamed and leaped back, dropping the pitcher on the purse, which only got it snarling at her.

Dr. Duffel jumped up, grabbed her cell phone (which hadn't rung), mumbled "I have to answer this outside" and dragged her growling purse out of the room. I'm pretty sure it wasn't her ringtone.

She never came back.

I rinsed off my shoes when I got home.

Thursday, January 28, 2010

Whatever

Mrs. Sad: "Some days I feel like I have no one to talk to."

Dr. Grumpy: "What do you do when that happens?"

Mrs. Sad: "You mean when I have no one to talk to?"

Dr. Grumpy: "Yes"

Mrs. Sad: "I talk to someone about it."

Plumbing FAIL!

"I know I have bleeding somewhere in my colon, because every time I urinate bright red blood comes out."

(yeah, I'm sure someone will write in that maybe the patient has a fistula, but trust me, that ain't the case)

Things that make me grumpy

YOU!

Yes, you. You make me grumpy. Pissed off. Wanting to leap across my desk at you, if you were to ever come back here again, which you won't.

You were here last week for a disability evaluation. You looked miserable. Your friend pushed you up here in a wheelchair, and you used a cane to get from the chair into my office.

You were very polite. You told me how nice I was. You said that I "wasn't like the other insurance company docs" you'd been sent to. You even brought Mary some chocolate-covered berries for working you in so quickly.

I could see you were trying to butter us up. I'm not that stupid. But you did seem legitimately suffering, and were quite patient while I reviewed the boatload of test results your company had sent me.

I've been doing this long enough that I could see you were exaggerating some things, but you did seem to have some real limitations.

Anyway, I didn't complete your disability report over the weekend. Sorry, but I was on call. I put it off until this week, and boy, am I glad I did.

A DVD from your insurance company showed up in my mail yesterday. I've been watching it.

It's kind of interesting. It actually shows you leaving my medical building last week, after the appointment. I guess you were in too much pain to see the camera guy following you around, huh?

It was kind of neat how you stood up and began walking as soon as you got to the parking garage. I kind of expected you to yell "Hallelujah! It's a miracle!" like they do on TV, but you didn't. You just folded up the wheelchair, handed the cane to your friend, and walked over to your car.

You'd told me that you hadn't been able to drive for a year, so it was kind of surprising watching you get behind the wheel. I guess with your miraculous recovery you had an itching to try out the old motoring skills, huh?

I then watched a boring clip of you going over to Local Grocery. No biggie. But I loved it when you drove to Home Depot. You told me you couldn't lift more then 5 pounds at a time. I haven't bought paint in a few years, but those big metal cans, I'm pretty sure, weigh more than that. And you were carrying one in each hand.

After you got home there's a few hours missing. Maybe you were inside recovering from the horrible pain you'd suffered heroically buying salad dressing and paint. But when you emerged carrying a ladder, and began painting your front porch, I just lost it.

So, as you requested, I've now completed the forms listing my findings and what I think the extent of your disability is. And I personally faxed them to your company. And called to make sure they got them.

Have a nice day.

Wednesday, January 27, 2010

WTF were they thinking?

As an Apple fan going back over 25 years, I have to wonder WHAT THE HELL WERE YOU THINKING? "iPAD" WAS THE BEST FUCKING NAME YOUR BILLION DOLLAR MARKETING DIVISION COULD COME UP WITH?

What the hell, Steve? What about iTop? or iScreen ("i scream, you scream, we all scream for iScreen")? or iANYTHINGELSEBUTIPAD?

Even Failblog got into the joke today.


Mary's Desk, January 27, 2010

Dr. Grumpy: "Have you sent those reports over to Dr. Freek yet?"

Mary: "I've been trying, but they're not going through. And it's been busy today."

Dr. Grumpy: "A lot of calls?"

Mary: "Yeah, but most are hang-ups or a fax or something."

Dr. Grumpy: "Why aren't the reports going through to Dr. Freek?"

Mary: "I have no idea. They just aren't. Are you sure about the fax number you gave me?"

Dr. Grumpy: "I think so, let me see it... Yeah, that looks familiar, I think it's his number."

Mary: "Okay, I'll keep trying... HEY!"

Dr. Grumpy: "What?"

Mary: "You dipshit! That's OUR phone number you told me to fax it to."


(long pause)


Dr. Grumpy: "Well, you didn't catch it either."

Mary: "You wrote it down! Not me!"


(another pause)


Dr. Grumpy: "Well, at least now we know why you're getting so many hang-ups today."

Mary: "Go back to your office! I'll tell you when you're allowed to come back out!"

Go Away!

I wandered up front to see my least-favorite drug rep, Rikki Phoneysmile, standing there.


Rikki: "Hi, Dr. Grumpy! Do you need any samples of Fukitol today?"

Dr. Grumpy: "Actually, yes, I'm all out."

Rikki: "I don't have any right now! Sorry!"

A Little Help Here, Please

Come on, somebody say something stupid! I've got a blog to write, damnit!

Geez. So far nothing blogworthy today. This sucks.

Tuesday, January 26, 2010

The hits keep coming, folks

Mrs. Hyve: "I'm allergic to all medications. I'm even allergic to Benadryl."

Dr. Grumpy: "What happens?"

Mrs. Hyve: "All medications give me a rash, so to safely take any pill, I have to take another pill first, to prevent the rash from happening."

Dr. Grumpy: "What do you take to keep the rash from occurring?"

Mrs. Hyve: "Benadryl."

Medication fun

Dr. Grumpy: "Are you still taking Ambien?"

Mr. Insomnia: "No, it stopped working, so my doctor switched me to Zolpidem, and that's much better."


(For my non-medical readers: Ambien and Zolpidem are the same medication)

I'm Living in "Airplane"

This morning I ordered a few bottles of Botox.

Miss Waytoohappy: "Okay, Dr. Grumpy, that's 4 bottles of Botox, and we'll get this shipped out today! Would you like a confirmation number?"

Dr. Grumpy: "Sure, what is it?"

Miss Waytoohappy: "It's a number we give you that allows you to reference this order if there are any problems or questions."

Strange things to find in the playroom, part 2

(for Part 1, click here)

Last night the boys borrowed Marie's Cinderella castle set, but told her they didn't need the dolls.

An hour later I wandered by and noticed this.

(click to enlarge)


Monday, January 25, 2010

Irrefutable logic

Dr. Grumpy: "You look kind of unsteady today."

Mr. Woodstock: "Yeah, I smoked a few joints out in my car before coming up here."

Dr. Grumpy: "Why did you do that?"

Mr. Woodstock: "I was really nervous about coming in today."

Dr. Grumpy: "Why were you nervous? You've been here before."

Mr. Woodstock: "Oh, not about that. I've been drinking scotch all morning, and didn't want you to notice I was drunk when I came in. I've never been drunk to a doctor visit before, so I smoked some weed to calm down, because I didn't want you to think I'd been drinking."

Do you enjoy wasting time?

Look, lady, I don't treat Glermfronger's disease*.

I've never treated it. I mean, I know some neurologists do, but most of us don't. It requires some additional training that I don't have.

In fact, when you called last week, both Annie and Mary told you I don't, and tried to give you some names of docs who do. You insisted on making the appointment with me anyway, saying you had "other neurological issues", too.

So, now that you're here, you tell me that you really don't have other issues, and you just made the appointment to discuss your Glermfronger's. And guess what? I still don't treat it. You coming into my office didn't magically give me the ability to treat it, like you apparently thought it would.

And handing me an insurance auth from your family doc saying "refer to neurology for Glermfronger's disease" doesn't miraculously make me treat it, either. So stop repeatedly showing it to me.

Oh, I get it, if it's on your insurance auth it MUST be true.

And now you tell me that there actually is a neurologist on your insurance who does treat it, but she's 5 miles from your house, and I'm only 3 miles. So you thought you'd lie to get in here, hoping to save some driving.

Well, you've now wasted a 1 hour slot for both of us, and your crappy insurance won't pay me for it, and someone else who needed to come in today is waiting for another day because of your selfishness and stupidity.

People like you make me wish I had a trap door under that chair.


*Not a real disease, but I'm using it for anonymity.

Attention Dr. Pissy!

Since I was on call this weekend, I appreciate you picking up the next week's soda supply for the office.

However, you have erroneously purchased Local Grocery Generic Brand CAFFEINE FREE Diet Soda.

You are never allowed to do the office shopping again. Ever. And I'm reporting you to your wife.

And if the staff uses up all the Provigil samples this week trying to function, it's your fault.

Sunday, January 24, 2010

Dénouement

Aw, gee, they're towing Dr. Prik's car away.

What kind of asshole would have called security to report the expired placard?

That's a shame.

Sunday Morning, 4:05 a.m.

Bleary-eyed, I stumble into the doctor's lounge. I'm on call. I have a migraine, though the medication is starting to take effect. I'm sleep deprived. I forgot to grab a Diet Coke on the way out of the house. I need caffeine, calories, and fluids.

It's been picked clean. No bagels, bread, or muffins. Shelves empty. Refrigerator empty. Coffee machine broken and overflowing into the sink.

After a careful search I found:

3 packets of melba toast.

1 packet of fat-free, calorie-free, taste-free cream cheese.

And an 8 oz. can of caffeine-free diet RC cola that was lying between the refrigerator and the sink. It was covered with dust bunnies and warm from the fridge motor. The hospital hasn't carried RC in years.

This sucks.

Saturday, January 23, 2010

On Call, Again. Live the Adventure

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

Mr. Cabbage: "Yeah, I see Dr. Nerve for my back problems, but for the last 2 hours I've had this heavy chest pain, too."

Dr. Grumpy: "Sir, you need to go to ER for that. NOW!"

Mr. Cabbage: "I don't want to. Can't you give me a pain pill or something?"

Dr. Grumpy: "NO! I'm a neurologist, sir. And chest pain is scary. You need to get it checked out ASAP. Do you have a cardiologist?"

Mr. Cabbage: "Yeah, but I already called him. He told me to go to ER, too."

Dr. Grumpy: "Then why are you calling me?"

Mr. Cabbage: "I hate going to ER, so I thought I'd call some of my other docs for ideas.

Dr. Grumpy: "You need to go to ER."

Mr. Cabbage: "My internist said that, too."

Dr. Grumpy: "Look. This could be serious. If you don't go, that's your business. But ER is the best advice I can give you."

Mr. Cabbage: "You're no help at all. I'll call some of my other docs. Thanks for wasting my time."

(click)

Things that make me grumpy

This morning I went to the hospital to round. As I was walking in, I ran into Dr. Prik, who'd parked in a handicapped space near the hospital entrance. He had a handicapped placard hanging from his rear view mirror.

He looked fine, but being a neurologist I know that many people who legitimately need handicapped spaces can look fine at first glance.

Dr. Grumpy: "You doing okay?"

Dr. Prik: "Yeah, fine. How about you?"

Dr. Grumpy: "Oh, I just saw the handicapped thing."

Dr. Prik: "Yeah. That was from when my wife broke her ankle a few years ago."

Dr. Grumpy: "I remember that."

Dr. Prik: "She's fine now. I just hold onto it. I hate having to walk too far to the building when I'm on call."


So, Dr. Prik, you hereby win the "Golden Asshole Physician Award" for your jackass sense of entitlement, and for your contributions to making the rest of us look like scum.

Also, you win the "Phailed Physically Phit" award for showing another reason as to why people are fat. Because YOU'D rather not burn a few extra calories, and at the same time ensure that someone who needs a decent space won't get one.

Friday, January 22, 2010

Mary's Desk, January 22, 2010

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

Mr. Pancake: "Hi! This is Bill Pancake. I have an appointment with Dr. Grumpy this afternoon."

Mary: "Um, yes, at 2:15."

Mr. Pancake: "Well, I'm right across the street having breakfast, so I want to come in now."

Mary: "Let me see... I'm sorry, we're completely swamped this morning, and can't do that."

Mr. Pancake: "Well you're not very accomodating."

Mary: "I'm sorry, it's just very busy today. Normally we would."

Mr. Pancake: "That's rude! I'm already here! I don't want to have to go all the way back home."

Mary: "I thought you lived in the apartment building across the street, within walking distance?"

Mr. Pancake: "What does that have to do with it?"

Bwahahahahahaha!

The rivalry between doctorhood's medical and surgical branches goes back to Hippocrates, and has led to some friendly (and not-so-friendly) ribbing over time.


There's a surgeon upstairs in my building, who I've treated for migraines for a few years. Yesterday he had a severe headache, which was different from his usual ones. I was worried something bad had happened, so I admitted him to the hospital, and ordered a bunch of tests.

At around 9:00 last night I got paged by the radiologist with the MRI results.

Dr. Grumpy: "What have you got?"

Dr. Radar: "I'm looking at Dr. Surgeon's head MRI. It's very abnormal."

Dr. Grumpy: "Crap. What's up?"

Dr. Radar: "He has a large intracranial soft tissue mass, which is almost never seen in surgeons."


I was laughing so hard I had to get off the phone (the study was fine, folks).

Thursday, January 21, 2010

More hairs fall out

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

Mr. Tremor: "My hands shake."

Dr. Grumpy: "How long has this been going on?"

Mr. Tremor: "Since they started shaking."
 
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