MARY!!!!!!!!! HELP!!!!!!!!!!!

Dr. Grumpy: "Any changes in your health since I last saw you?"

Ms. Doda: "No, nothing ... Oh wait, I had surgery last fall."

Dr. Grumpy: "Okay, was it..."

Ms. Doda: "I got boobies! Implants! Check these girls out!"

(Whips off shirt)

Seen in a chart

This is how a note I received from a neurosurgeon ended. Thanks, guys, that really helps.

Bon appétit!

Like many offices, we have a small dish on the front counter full of generic hard candies (peppermints, butterscotches, Werther's, Jolly Ranchers, etc.).


Lady waiting for her appointment comes up to front counter.


Lady: "Can I have one of these candies?"

Mary: "Sure. Help yourself."

Lady: "Thanks. I didn't have time to get breakfast today."


She picked up THE WHOLE JAR, carried it back to her chair, and in the space of about 5 minutes unwrapped and crunched through about 20 pieces of hard candy.

Then she brought the empty jar back to Mary, full of wrappers.


Lady: "Thanks."

Overheard at the nurse's station

"BITCH! You're the worst nurse ever! Get the fuck out of my room! But first, get me more morphine!"

May, 1927

89 years ago this week...

Charles Lindbergh is a household name. Children learn at a young age that he was first person to fly non-stop between New York and Paris in the Spirit of St. Louis.

But 2 weeks before his famous flight, a brave pair of Frenchmen took off from Paris planning to fly nonstop to New York, and have their names enter the history books instead of their American rival.

Francois Coli and Charles Nungesser

Instead, they vanished.

Francois Coli and Charles Nungesser (ages 45 and 35) were both excellent pilots. Coli was a highly decorated veteran of WWI, who'd been making record-breaking distance flights across the Mediterranean Sea for several years. Nungesser was also a talented flier, and France's 3rd most successful ace in WWI. Like their American contemporary, Charles Lindbergh, they were chasing the $25,000 (in 1924 money) Orteig Prize, which would be awarded for the first nonstop New York-Paris flight across the Atlantic.

They spent 2 years modifying a Levasseur PL.8 biplane, adding extra fuel tanks and reinforcing the structure for the long flight to come. The engine was run in the factory for over 40 consecutive hours to test its reliability. The bottom of the plane was rebuilt so it could land on water, and their plan was to arrive in front of France's gift to America, the statue of Liberty, to complete the record breaking journey. A wheeled carriage would be used for take-off from land, then dropped. The plane was painted white and named L'Oiseau Blanc - "The White Bird."

Their route was an arc over the northern Atlantic, taking them from Paris, across the English Channel, England, and Ireland. On the other side of the Atlantic they'd gradually turn south and fly over Nova Scotia, Maine, Boston, and finally come down in New York harbor. They had enough fuel for 42 hours of continuous flight, and were going at a time of year known for better weather. Coli was one of the best navigators of the era - in an age where flights over water relied entirely on celestial navigation. Like most planes, they had no radio.

The guts to do this sort of thing must have been remarkable. For the most part we take long-distance flying for granted today. But at that time they were using technology as unproven to them as the earliest space flights were to another generation. The planes were wood, metal, and cloth. Engine reliability was iffy at best. Navigation was largely educated guesswork. The White Bird's cockpit was open to the elements, and behind the wings. They had nothing over their heads, so were exposed to wind, rain, and cold.

At 5:27 a.m. an May 8, 1927, they took off from Paris's Le Bourget Field, dropping the wheeled sled that was used for the take-off. Within minutes the electric signal had been received in New York that the White Bird was on its way. Crowds in Paris watched as they disappeared into the distance. They continued over England and Ireland on their way into the history books. The last man to see them was a priest in Carrigaholt, Ireland.

On May 10, large crowds gathered in New York to watch the historic arrival. No one had ever flown from Paris non-stop, and it was a big day in the development of the amazing airplane.

But it was not to be. The White Bird never appeared. After several hours of waiting, the crowds dispersed, not knowing what had happened to the 2 brave Frenchman.

And 89 years later, we still don't know.

For 2 weeks, the armed forces of France, England, Canada, and America scoured as much of the Atlantic and northeastern North America as possible. But no trace of them was ever found. Writing of their attempt afterwards, Lindbergh noted they'd "vanished like midnight ghosts."

For several years it was assumed they were victims of a storm, or navigational error, or mechanical problem. The North Atlantic is cold, gray, foggy, and unforgiving. If they were forced to come down far from land, they'd have no real chance of survival. A navigation error could put them far off course, heading for desolate areas as their fuel ran out.

But the odds are that they didn't fail entirely.

As years went by, disparate stories drifted in. Fishermen in remote Newfoundland communities seeing a white plane pass overhead on May 9 (in that era an airplane sighting was a rarity). Reports from small towns through Nova Scotia and into Maine, where residents noted either a white plane going by, northeast to southwest, or the sound of an airplane engine above the clouds. One local newspaper even reported a "mystery plane" passed overhead on that day. These were from areas likely unaware of the White Bird's attempt.

The stories, initially disconnected, meant little. But as researchers dug there were 2 common threads: they all took place on May 9-10, 1927, and all were in a line that sequentially followed the final leg of White Bird's planned course to New York City. In that era there were no other planes that would account for them.

And the reports stopped somewhere in Maine.

Anson Berry (died 1936), a hermit outside of Machias, Maine, knew nothing of the White Bird and didn't read newspapers. But on trips to buy supplies, he told many townspeople about a day in May, 1927, when he'd heard a low-flying plane engine sputtering somewhere above the clouds... Followed by a loud crash in the distance.

Rumors have cropped up over time. A plane wreck seen in a lake. A ruined engine, possibly from a plane, found in the forest and sold for scrap. A few odd pieces of metal and wood have been collected in the area, but nothing that can clearly proven to have been from the plane.

Two weeks after the White Bird vanished, Charles Lindbergh made the first successful non-stop New York - Paris air crossing in the Spirit of St. Louis. Although evidence suggests the Frenchmen beat him by 2 weeks, their exact landing place and fate remain a mystery. Perhaps someday it will be solved.

On the cliffs of Étretat, in France, is a monument to mark the last place Nungesser and Coli flew over their homeland as they headed west.

Near their take-off spot at Le Bourget field is a monument to both they and Lindbergh, inscribed "A ceux qui tentèrent et celui qui accomplit" ("To those who tried and to the one who succeeded").

At the nearby French Air & Space Museum, is the only proven relic of their brave journey: the wheeled sled that the White Bird used for take-off, and then jettisoned.

Time out

All fine here, but due to some unanticipated family craziness I have to take a week or two off from the blog to catch up on other stuff. Sorry, but I promise that I'll be back.

Harmony

Him: "Am I your token black patient?"

Me: "No. Am I your token Jewish doctor?"

Pause

Him: "Dude, I like you."

Just another manic Monday

Mrs. Fennec called, asking for an urgent appointment. Mary had an afternoon slot open, and put her in.

She came in with her dog. This isn't uncommon in my practice, so I didn't think much of it.


Dr. Grumpy: "So what's going on? Mary said you had an emergency?"

Mrs. Fennec: "Yes! Fluffy ate my bottle of Strokoxx!"

Dr. Grumpy: "Uh, are you okay?"

Mrs. Fennec: "I'm fine! But what should we do about Fluffy?!!!"


(I look at Fluffy. He looks at me and cocks an ear to the side.)


Dr. Grumpy: "Well, you should take him to your vet to get this checked out."

Mrs. Fennec: "BUT YOU'RE THE ONE PRESCRIBING THE STROKOXX!!!"

Dr. Grumpy: "Yes, but I have no idea what it does to dogs. Or how to handle it. Or much about dogs at all. Who's your vet? Why don't I call and tell them what's going on, and you can head over there..."

Mrs. Fennec: "It's YOUR medication. You prescribed it! So you should be handling any issues it causes."

Dr. Grumpy: "Well, yes, as far as people go. But not dogs."

Mrs. Fennec: "You're refusing to treat Fluffy because he doesn't have insurance!"

Dr. Grumpy: "This has nothing to do with money. I'm not a veterinarian. You need to take him to someone who knows what to do for him."

Mrs. Fennec: "This is ALL YOUR FAULT, and I'm going to send you the vet's bill!"

(She got up and stomped out. Fluffy, I swear, looked back and winked at me.)

Specificity

Dr. Grumpy: "Have you ever had physical therapy?"

Mr. Vague: "Yeah."

Dr. Grumpy: "Where?"

Mr. Vague: "I don't know. It was a therapy place."

Dr. Grumpy: "Do you remember where it was?"

Mr. Vague: "Somewhere around Grumpyville, I think."

Seen in a chart

Friday re-runs

While at Local Grocery after work I was sighted and approached by a patient.

An Alzheimer's patient.

Bill.

Bill: "Uh, excuse me? Hello."

Dr. Grumpy (looking up): "Yes, I, oh, uh, hi"

Bill: "I know you, um" (he leaned forward, and I realized I had my hospital ID clipped to my shirt) "You look familiar, um Ibee Grumpy?"

Dr. Grumpy: "Yes, Bill, how are you?"

Bill: "Don't tell me, it'll come! I know! You work here!"

Dr. Grumpy: "No, Bill, I'm..."

Bill: "Can you tell me where breakfast cereals are? My wife asked me to get some Corn Flakes."

Dr. Grumpy: "Uh, aisle 16, that way, about halfway down."

Bill: "Thank you."

As he walked away I realized he had a box of Corn Flakes in each hand.

Mary's desk

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

Ms. Stannum: "I need to see the doctor, but want to ask some questions first."

Mary: "Okay, what can I help you with?"

Ms. Stannum: "I'm having terrible problems on my left side, and I need to know what's going on. But I can't have any tests, so is he the kind of doctor who will order them?"

Mary: "Well, that's something he would have to decide during the appointment, but I can tell you that he does order MRI's and labs, and...."

Ms. Stannum: "DIDN'T YOU JUST HEAR ME? I said I can't have any tests! I'm deathly allergic to the metal used in needles to draw blood and those electrodes they put on your skin!

Mary: "All right, but..."

Ms. Stannum: "And the magnetic rays and X-rays that scanners give off devastate me. I mean, I've had them in the past from all my other neurologists, but then I'm bed-bound for weeks afterwards. WEEKS. Last time I had to take short term disability until I could recover from the effects they have on my brain waves."

Mary: "Maybe you..."

Ms. Stannum: "And I can't take any pills. The chemicals they use in them are all poisons to me. I've nearly died from them thousands of times. LITERALLY. THOUSANDS! So I need a doctor who can help me get better, but who won't make me have any tests or take any pills."

(pause)

Mary: "I don't think Dr. Grumpy and you would be a good match. You might want to try another office."

Ms. Stannum: "That's the problem with modern medicine. Nobody cares about helping sick people."

(click)

Texting with Frank

I wandered out to put stuff in my car, to discover a large penis drawn on the dirty back window.

Obviously, I need to wash my car more often.

This sort of thing generally indicates Frank is the perpetrator, so I texted him.

April 11, 1755

Today is International Parkinson's Disease day.

Parkinson's Disease is something I deal with a fair amount. As most know, it's a progressive neurological disease typically characterized by tremor, imbalance, and slowness of movement.

And that's all I'm going to say about it here.

So why did I bring it up? Because the man behind the disease is fascinating. Mostly remembered now only by the neurological disorder he described, there was a lot more to him. Probably one of the more remarkable figures of his (or any) time.

James Parkinson was born on this day in 1755. His father, John, was a London pharmacist and physician. While a medical student, in 1777, James and his father received medals for successfully resuscitating a man who'd hung himself.

During medical school he wrote a pamphlet about his experiences called "The Medical Pupil." Perhaps this could be seen as an early example today's med student blogs. In words that still ring true 240 years later, he opined that "a sympathetic concern, and a tender interest for the sufferings of others, ought to characterize all those who engage themselves in the profession, the object of which should be to mitigate, or remove, one great portion of the calamities to which humanity is subject.”

Preach it, brother James.

In 1784, upon John's death, James took over the practice. It was a successful one, treating rich and poor alike. He also served as the supervising physician at a large local mental institution. He married Mary Dale, and they had a total of 8 children, 6 of whom survived to adulthood.

Parkinson was politically active and, for the time, radical. He strongly supported equal rights for the poor (OMG!), voting rights for women (gasp!), and the inclusion of "ordinary citizens" as a major portion of government. He campaigned extensively for decent treatment and legal protection of the mentally ill, realizing that those with serious illnesses were often incapable of recognizing their actions.

He wanted annual elections to make sure parliament turned over with "new minds" frequently, and supported the French Revolution across the channel. He wrote and published numerous political pamphlets, but to protect his family and practice wrote under the pen name "Old Hubert." When a political group he was involved in was falsely accused of plotting to assassinate King George III (the Pop-Gun Plot), Parkinson refused to testify against his friends. Eventually all charges were dropped when it was revealed they were trumped-up by political opponents.

During his medical career he published a treatise on gout and went on to write the first English language description of acute appendicitis. He and his son (also James, and also a doctor) were the first to prove that death from appendicitis was due to visceral perforation and infection.

As a member of the Association of Apothecaries (later its president) he saw a key act passed in 1815 that, for the first time, regulated the standards to which doctors and pharmacists had to be trained. He was also instrumental in passing laws concerning apprenticeships, setting goals for training and protecting the apprentice from abuse.

He wrote medical & science columns for popular newspapers on such varied subjects as chemistry, nosebleeds, and hypochondria, and also published scientific papers on topics as disparate as lightning, fossils, and geology.

In the 1810's, based on observations of both his own patients and  individuals he'd seen walking around London, he first recognized the characteristic tremor and shuffling gait of the disease that today has his name. He also differentiated between the types of tremors commonly seen - a key diagnostic point still used by neurologists today.

In 1817 he published his landmark piece "An Essay on the Shaking Palsy" in which he described the main features of the disorder. The accuracy of the paper in describing the condition is made all the more remarkable by the fact that neurology as a field didn't exist at the time. Jean-Martin Charcot, the Frenchman who would go on to found my medical specialty, was born 8 years later in 1825. It wasn't until 1877, 60 years after Parkinson's essay, that Charcot himself named the condition Parkinson's Disease. His English colleague, William Gowers, agreed with Charcot's eponym.

Sadly, this discovery obscured many of his equally remarkable accomplishments.

Besides those interests mentioned above, Parkinson's scientific curiosity led him in many directions. He examined rock specimens at length and wrote a breakthrough treatise on the sediment patterns and fossils seen through the British Isles, recognizing the organization and significance of different rock strata.

He authored 2 books on fossils from around the world, describing them as earlier stages of currently living animals (Darwin's theory of evolution wouldn't be published for another 40 years). He also did his own black & white illustrations for the books, while his daughter did the color plates.

A species of Ammonite, a long-extinct relative of the modern octopus and squid, was named after him. So was an ancient branch of the turtle family. He has the unusual distinction among scientists of having both a disease and fossils attached to his name.

In 1823 the Royal College of Surgeons presented him with an award for his extensive body of work, noting “The fruits of your exertions are distinguished by the stamp of simplicity and truth. They express the most laudable zeal in the pursuit and the promulgation of knowledge, for the benefit of mankind.”

James Parkinson died on December 21, 1824 of a stroke, very close to where he was born and spent his entire life and practice. He was buried at St. Leonard's church, though no stone was placed and the exact location of his body is unknown.