Thank you for sharing

Dr. Grumpy: "I'll have Annie set up an MRI for you, and in the meantime..."

Ms. Rope: "Hey, do they have to tie me down to do the MRI?"

Dr. Grumpy: "No, not at all."

Ms. Rope: "That's too bad. I'm into that sort of thing."

Reflections

This post isn't funny. But I mean every word.

November 6 is always a day of special meaning to me. My first secretary (Kate) called it Independence Day.

It's the anniversary of my going into solo practice. Which, after many years, is still one of the best decisions of my life.

As most of you know, I started out with Humungous Neurology, but after a few years I got sick of endless partner meetings (AKA sociopath's roundtable), bizarre fluctuations in my allegedly fixed salary that no one could explain, office politics, and the utter bullshit that seems to come with a large medical practice. Accountants showing me charts of dollars earned vs. square footage of office space used per patient drove me nuts.

Most of the other docs at Humungous Neurology, Inc., told me I wouldn't make it on my own. That I'd be back soon. That there was no place in modern medicine for a solo doc.

But I left anyway. It was a gutsy move. I had a 1 year old. Mrs. Grumpy was pregnant with twins, and couldn't work. I hadn't run a business since age 12, when I sold used golf balls (I fished them out of a lake on a nearby course, and sold them from a card table to passing golfers). My dad helped me form a corporation, and connected me with a friendly accountant he knew.

Kate (who was here before Mary) and Annie came with me from Humungous Neurology, Inc. But my first receptionist was - my mom.

To add another item to the list of terrific things Mom has done, she became my first receptionist when Kate had to go out of town that first week. She patiently answered the phones and made notes in a scheduling book, while I frantically tried to get the phones and computers to work properly. I didn't see a single office patient that week due to a phone system meltdown (it traumatized me so much that I've never changed it since).

Kate left me after 4 years to take a job closer to her home. I was afraid I'd never replace her. I spent a sleepless night at home, and the next morning she introduced me to Mary, who she'd met working for another doctor in the building. She'd found her own awesome replacement in only one day. And Mary is still here, and still totally awesome.

Annie and I have now been together for a total of 14 years, and I can't imagine doing this without her.

I have no regrets about solo practice. It was a self-taught crash course in business: insurance, payroll, withholding taxes, purchasing supplies, etc. It certainly isn't for everyone. But when it's all said and done, I prefer this more than any group. Nobody argues with me about my choice of computers, or EMG machine, or ISP, or whatever. Nobody makes me look at Powerpoint presentations on lobby decor. And nobody shows me charts of dollars earned per square foot per patient.

I'm writing this to say "thank you" to those who have made it possible for me to be here: Annie, Kate, Mary, my parents, and (of course) Mrs. Grumpy. It takes a hell of a lot of patience (and too many other qualities to list) to put up with me.

And, of course, the patients. Without whom I'd have no practice or blog.

Thank you all so very much.

IG

Working on commission

Commission Guy: "Can I help you, sir?"

Dr. Grumpy: "I need a new iPhone case, one with a belt clip. Mine wore out and broke."

Commission Guy: "I can help you with that. You want one that lights up when you're talking?"

Dr. Grumpy: "No. Don't get me started on that."

Commission Guy: "All right, how about this one. It's on sale!"

Dr. Grumpy: "It's kind of thick... Not sure I need that."

Commission Guy: "It's a great deal, though! Normally $289, this week only $199!"

Dr. Grumpy: "ONLY $199? Uh, no, I just need something to protect it from scratches and stuff, like this $15 one here. Hey, do you have this kind in black? And with a belt clip?"

Commission Guy: "Yeah, but that won't protect your iPhone. You just said your last case broke. You need something sturdier."

Dr. Grumpy: "Maybe, but I'm not paying $199 for an iPhone case."

Commission Guy: "Your phone could get wet or dropped or something. Look at this case as an investment."

Dr. Grumpy: "Okay, I'm taking this one for $15 and going to check out. Thank you."

Commission Guy: "Wait! This $199 case is a great deal! It's bullet proof!"

Dr. Grumpy: "BULLET PROOF?"

Commission Guy: "Well, against a small caliber handgun, I mean. Couldn't you use that in an iPhone case?"

Dr. Grumpy: "I wear my phone on the right side of my belt. So, yes, if I'm worried about someone sneaking up and shooting me in the right hip I suppose it's useful. But I think I'll take my chances with the $15 case."

Commission Guy: "But..."

Dr. Grumpy: "Besides, if someone is shooting at me, the safety of my iPhone is the least of my worries."

I left and went to another store, where I got a cheap case. Upon getting home my curiosity got the best of me, and I looked online. The only bullet proof iPhone case I found was $650, and didn't look anything like what he was trying to sell me.

And then I had these visions of Linda Carter, in a 1977 Wonder Woman outfit, using an iPhone instead of her magic bracelets to deflect bullets while fighting bad guys.

Fun with online medical surveys

What happens to the documents if I take the survey in French?

Claustrophobia

"Doc, I was a Navy Seal. We trained in all kinds of stuff. I got crammed into the torpedo tubes of a submarine to land on enemy islands. I sat balled up in a fetal position for hours in the dark cargo hold of a bomber to parachute out. I fought in combat in 2 wars. But holy shit, I couldn't handle that MRI to save my life."

Dear Patient,

I know you did it. Why, I don't have a clue.

A blue sponge that I use once a week for cleaning Ed's bowl has been sitting on the edge of that sink for 12 years. The sponge changes every few years, usually when it starts falling apart. It's not used for anything else.

I'd noted it there when I took you in. Mary pulled me out for 5 minutes to take an ER call, and when I went back in it was gone. You were standing in the center of the room, zipping your purse closed. And the sponge had vanished.

I gave you the benefit of the doubt, but a search of the room didn't turn it up. So I took emergency measures, and brought a new one from home the next day.

I have no idea why anyone would want to steal a used sponge, especially from a doctor's office. I mean, it's nowhere near the kitchen, and since its sitting next to a fish net and bottle of Betta water prep I figure it's pretty obvious what it's for (sorry if I came back you before you could grab the net, too).

The sponge has been used to scrub off countless fish turds, the fuzzy goop that grows on the glass balls at the bottom during the summer months, and whatever other disgusting things are in Ed's water. I hope you aren't using it in your kitchen, or for personal hygiene.

I don't think you're so destitute as to be unable to afford one (they cost 25¢, FFS). I also hope you didn't mistake it for some kind of snack, and are now lying in ICU dying of some horrible fish shit poisoning.

Perhaps you're secretly planning on taking it to the state board of health, to see what they can culture out of it. If the plan is to get me in trouble with them, I doubt they'll care. I'm not preparing food or medicine in that sink, or washing anything. It's used solely for changing a fish once a week.

However, we know who you are. If you read this, and are currently overwrought with guilt from your life of crime, please confess at your next appointment. In exchange I will not press charges, but will gladly give you an unopened, clean, kitchen sponge, as I feel sorry that you must resort to such lawlessness.

Yours truly,

Ibee Grumpy, M.D.

p.s. I also have an extra fish net if you need one.

Communication

Dr. Pissy still uses paper charts, and has a room near my office where he stores inactive ones.

1-2 times a year his secretary makes a list of patients who have died, and moves their charts from the front shelves to a box in the storage room.

Yesterday I was talking to Mr. Patient in my office, when Pissy's secretary wandered past my door behind him. She was struggling with a pile of charts, and looked like she might drop one at any minute.

Being a gentleman (or at least trying) I stopped talking to Mr. Patient and called out, "Hey, do you need a hand with those?"

Pissy's secretary said "No, I'm okay. I'm just putting a bunch of dead people in a box."

Mr. Patient looked startled, to say the least.

I just had to do it

I was on call this weekend, and overheard...


Unit clerk (flipping through a Rolodex) "Hey, does anyone know Jenny's number?"

Dr. Grumpy: "867-5309."

Hurricane news

As the warnings for Hurricane Sandy continue to come in ("Please remain calm, we could all be killed"), my reader Tanya noticed this incredible combination of weather alerts and an advertisement on her TV:

Thank you, Tanya!

p.s. I apologize in advance if I'm unable to post for the next few days due to power outages.

The Marines: Looking for a few good men

Tomorrow, in Washington, D.C., is the Marine Corps Marathon.

My reader Amy, while trying to figure out traffic routes, discovered this, uh, interesting map of the marathon's course:

I AM NOT MAKING THIS UP! The complete map, including the above, um, segment, can be seen here.

Thank you, Amy!

Thanks, Siri

I've gotten into the habit of having Siri do minor stuff for me. Sometimes she works fine, other times... not so much.

Last night I had a marketing interview, which finished ahead of schedule. So as I got in my car I picked up the phone and said "Siri, send a text to Mrs. Grumpy: I'm done, the interview went fast."

Upon getting home I found out she received "I'm done. The interviewer and I went to France."

October 25, 1962

The North American black bear (ursus americanus) is the smallest of the continent's 3 bear species, and (comparatively) the most docile. It generally prefers to avoid humans and be left alone.


It was the Cuban missile crisis. The 2 superpowers were locked in a potentially lethal stare-down that affected lives across the globe. Both were on a hair trigger, watching for the other to make the first move.

Volk Field, in Wisconsin, wasn't one of America's larger bases. It was primarily used for pilot training and didn't even have a control tower. Planes were directed from a command center at Duluth.

In the current state of readiness, though, the Air Force had dispersed American warplanes to many such small bases across the north. Tensions were high. There was fear that Soviet agents would try to destroy the planes or runways prior to a first strike. Extra alarms had been hurriedly rigged up everywhere, alongside the dreaded klaxon that meant "launch nuclear bombers." Armed sentries patrolled constantly.

There were no drills. The pilots and planes were ready. The men had been told that, given the world situation, if the alarm sounded it was the real thing.

It was around midnight when a sentry patrolling the Duluth command center noticed a figure just outside the security fence. As he approached, it suddenly began climbing the fence, trying to get into the restricted area. This might be it. A Russian spy, trying to sabotage the bases to let the Soviets get in a first nuclear strike.

The guard fired his gun at the figure and hit the alarm button that warned of a ground intruder. The trespasser jumped off the fence and ran back into the forest on all fours- a large black bear. But the sabotage alarm had now been activated at all the bases under Duluth's command, sending armed guards racing to protect the planes.

Except at Volk Field.

Due to an undetected wiring error when the base was hurriedly readied for bombers, the nuclear war klaxon sounded there.

Fighter crews scrambled to planes. Their mission (likely one-way) was to intercept long-range Soviet bombers coming over the North Pole. Aside from other weapons, each American plane carried a single AIR-2 "Genie" rocket with a 1.5 kiloton nuclear warhead to be used against enemy formations. The Russians, once they detected American planes heading for them, would certainly retaliate in kind.

They taxied down the runway to Armageddon. Once airborne they couldn't be recalled- they were under orders to assume any ground communication telling them to come back was from the enemy. There was no control tower to correct the error before they took off.

A quick-thinking officer in the base's command center called Duluth, and learned of the mistake. There was no war, only an errant bear. He hurriedly jumped into a truck, turned on the flashing lights, and drove onto the runway, blocking the fighters from taking off and alerting them to the mistake. He was able to stop them just in time.

It was another close call.

Those involved didn't even know what had happened for another 25 years, when the incident was officially declassified.

Life on the edge is scary.

Mary, call security.

Dr. Grumpy: "Are you married?"

Mrs. Latrodectus: "Widowed... Am I considered a widow if I killed my husband?"

Dr. Grumpy: "Um, I really don't know."

Mrs. Latrodectus: "Then just put down that I'm single."

Memories...

When I was in residency, there was a married couple in the program, Peter and Stephanie. They were often on call together, one supervising ICU and the other wards, or vice versa. Both were seniors, and I was just starting out.

One night when I was working with Peter, there was a code. Both on-call teams ran to it. Since I was the junior resident my job was to stay out of the way, but look like I was doing something important. Like leaning against a wall to keep it from collapsing.

Peter and Stephanie were at the head of the bed. She was setting up to intubate the patient, and Peter was watching the heart monitor and calling for meds (they were REALLY into this sort of shit. Another resident once told me that codes were probably their idea of foreplay). At one point Peter tore off a rhythm strip, handed it to me, turned back to the bed and yelled, "Sweetie! Can you intubate him now?"

There was a (pardon the phrase) dead silence.

The code stopped for a few seconds and all eyes were on the married couple. Finally, Stephanie said (with icicles on every syllable):

"Don't call me 'Sweetie' during a code."

Then she intubated the guy, and the code continued.

I don't remember if the patient made it, but I know I almost lost it.

Skool Nerse Time

Ms. Concern: "Hello?"

Mrs. Grumpy: "Hi, this is Nurse Grumpy, the school nurse at Douglas C. Kenney Elementary School, calling about your daughter, Karen."

Ms. Concern: "Yes?"

Mrs. Grumpy: "She took a bite of a friend's sandwich at lunch, and it had peanuts in it. Karen swelled up really badly, and had trouble breathing. I used one of our emergency EpiPens on her. She's much better now, and resting in my office."

Ms. Concern: "Okay. Do I need to send someone to get her?"

Mrs. Grumpy: "Yeah, but I went looking through her medical forms here. Did you know she's seriously allergic to peanuts?"

Ms. Concern: "Oh, yeah, she's been that way since she was five."

Mrs. Grumpy: "But on the allergy form you filled out just 2 weeks ago you wrote 'no allergies'!"

Ms. Concern: "That's because I don't have time for school paperwork."

Mrs. Grumpy: "Well, it really helps to have an accurate medical history, for when things like this happen."

Ms. Concern: "Her pediatrician knows, and I know. Why does it have to be your business, too?"

Mrs. Grumpy (sigh): "Do you have an EpiPen for her at home?"

Ms. Concern: "Of course. I keep two of them here."

Mrs. Grumpy: "Well can you please bring one to school? So we have it available in case this happens again?"

Ms. Concern: "They both expired years ago."

On the radio

This is the recording of an actual phone call to a Fargo radio station earlier this month.





Thank you, Tanya!

Family

Mr. Spouse: "What kind of side effects does this have?"

Dr. Grumpy: "A few. It can cause nightmares..."

Mr. Spouse: "Hell, so can my mother-in-law."

Literally

Dr. Grumpy: "Any major illnesses in your family?"

Mr. Clock: "My dad died early."

Dr. Grumpy: "Like in his 20's? Or 30's?"

Mr. Clock: "No, I mean between 4:00 and 5:00 in the morning."

Mary's desk, October 16, 2012

At the check-out desk.

Mary: "All right, so your follow-up appointment is next month, here's a reminder card... and this is your receipt for today's co-pay... Annie will call you to schedule the tests... Anything else?"

Mr. Suit: "Could you please fax something for me?"

Mary: "Sure, is it the form the doctor filled out?"

Mr. Suit: "No, it's this business report." (opens briefcase, pulls out HUGE folder and a list of fax numbers) "I need you to send a copy to my company's New York office, another to Calgary, one to Los Angeles, and..."

Mary: "Um, no. I thought it was something for your medical care. That sort of thing you'll have to have your own secretary do."

Mr. Suit: "Well, she's busy preparing reports like this."

Nigel? Are you out there?

I was doing an epilepsy survey last night and suddenly realized that

(drumroll)

This survey goes up to 11!!!

Coincidence

Mary usually shows up around 7:30 each morning. Today, at about 7:45, she called my cell.

Dr. Grumpy: "Hi, you okay?"

Mary: "Yeah, but I'm stuck in traffic, there's a big wreck at 12th and Carson. Looks like a blue car smashed into a truck, and the intersection is closed. It's going to be a while. Sorry."

Dr. Grumpy: "I'm glad you're okay. Don't worry about it. I'll see you when you get here."

I wandered up to her desk and got paperwork ready for the new patient coming at 8:00, then began looking through some MRI reports. As I was sitting there a voicemail came in:

"Hi, I have an appointment 8:00, and I'm not going to be able to make it.  Some asshole in a blue car rear-ended my truck on Carson street on the way to your office and..."

Picture day

Yesterday we made our usual weekend run to Costco to load up on Diet Coke and other life sustaining nutrients.

Starting in October, Costco puts up large displays of Christmas trees and other holiday home decorations, some of which can be quite elaborate, to show people how the items look out of the box.

As we walked around we noticed 2-3 families, each with their kids nicely dressed up in Christmas-type outfits. They were posing the youngsters in front of the displays and taking pictures for family Christmas cards.

Advantages of getting a flu shot

At your friend the pediatrician's office: Cool band-aids!

Patient quote of the day

"When things are the same they're the same, but when they're different they're not the same."

Practice makes perfect

I'm examining Mr. Patient, with his wife sitting off to the side.


Dr. Grumpy: "Okay, hold your hands out in front, like this... now close your eyes... good, now open your eyes, and tap your right fingers like this... okay, now your left fingers..."


Out of the corner of my eye I notice Mrs. Patient doing the same things I'm asking her husband to do.


Dr. Grumpy: "Ma'am, why are you doing that?"

Mrs. Patient: "Just practicing, in case I ever need to see a neurologist."

Great moments in Jewish parenting

"DAD! YOU DON'T KNOW WHAT IT'S LIKE THAT YOU TOOK AWAY MY NINTENDO 3DS! YOU TOOK AWAY MY DIGNITY TOO! THIS IS WHAT IT WAS LIKE TO BE ONE OF THE MACCABEES, WHEN PHARAOH MADE THEM WORSHIP HIS GODS AND MADE THEM SLAVES AND JUDAH SAW THE BURNING BUSH FOR 8 DAYS AND SENT MOSES WITH A MENORAH TO TELL THE ROMANS TO LET MY PEOPLE GO!!!"

Mary's desk, October 9, 2012

Mrs. Bulova: "Hello?"

Mary: "Hi, Mrs. Bulova. This is Mary, at Dr. Grumpy's office. I'm calling because you're 10 minutes late for your appointment, and you're always punctual. So I wanted to make sure everything is okay."

Mrs. Bulova: "That can't be! My appointment is at 2:30, and my watch says it's only 1:15 now!"

Mary: "I'm sorry, but it's actually 2:40. I can re-schedule you, though. Maybe your watch is broken? Or you need to wind it?"

Mrs. Bulova: "It's funny, I noticed last night that it said 1:15 while I was having dinner, and it said the same thing later when I was getting ready for bed, and also this morning, when I woke up. I thought that was weird, but it makes sense now."

Reasons to keep beer in the break room

Like most offices, we have stuff on the front counter. A clipboard with a sign-in sheet. A little clock. A pen holder. A plastic & metal cow-like thing that shows the date. Business card holders.

Yesterday a lady came in for an appointment, towing 3 toddlers with her. After signing in she took everything except the clipboard off the counter and handed them to her kids to play with!

When Mary asked her to put them back, she got angry and said "You act like this is my problem, that your office doesn't have stuff around to keep kids busy."

For those of you wondering: No. Neither of us sees kids in our practices.

Sunday

Yesterday I was at local mall with the kids, when they started whining about being hungry. So I took them to the food court.

While they were inhaling burgers, I got a phone call from the ER, and wandered off to a quieter area to talk. Without paying attention, I ended up standing next to a kiosk selling phone accessories.


Dr. Grumpy: "Is she on Coumadin?"

Kiosk Guy: (comes over, taps me on shoulder) "Hey! You need a new iPhone case!"

Dr. Grumpy: "No thank you, I'm busy right now. What did her head CT show?"

Kiosk Guy: "This one is on sale! It lights up when you're on the phone!"

Dr. Grumpy: (waves guy away again) "Who's her cardiologist? Do they know what's going on yet?"

Kiosk Guy: "Your phone case is falling apart! You should get this one!"

Dr. Grumpy: "Hang on, ERP... Look, this is an important call. Can't you see I'm on the phone?"

Kiosk Guy: "No! That's why you need a case that lights up!"

Weekend reruns

When the kids were younger, we had a part-time nanny named Syndee. I was anything but fond of her. I don't remember how Mrs. Grumpy found her.

Syndee did a good job with the kids, so I turned a blind eye to her many shortcomings (which could be several posts alone). Her main issue was a remarkable lack of IQ and common sense. It was not uncommon to realize she'd been outsmarted by Snowball (and he's slow). She occasionally still calls to see if we need a babysitter. Rarely she'll call me for medical questions, as she does not grasp the concept of what being a specialist means. She's also learned (since she knows our home number) that it's easier to reach me than her own doctor.

Last week Syndee got married, and went off to Hawaii for her honeymoon.

This morning, at 12:05 a.m., I was woken by our home phone ringing.

Dr. Grumpy: "Mmmph, hello?"

Syndee: "Hi! Dr. Grumpy! It's me, Syndee!"

Dr. Grumpy: "What the hell?... Syndee do you know what time it is?"

Syndee: "Sure! It's just after dinner! Why, is your clock broken?"

Dr. Grumpy: "No, it's after midnight here."

Syndee: "It is not! I wouldn't call that late!"

Dr. Grumpy: "Syndee, you're in another time zone."

Syndee: "What's a time zone?"

Dr. Grumpy (sigh): "Why did you call Syndee?"

Syndee: "Well, um, In the last few days I've developed a bladder infection and..."

Dr. Grumpy (seeing an opportunity to get even): "What the HELL have you been doing on your honeymoon to get a bladder infection?"

Syndee: "Well, um, my husband and me, um we, um... Can you just call in some antibiotics for me?"

Dr. Grumpy: "Why don't you call your regular doctor for this?"

Syndee: "Her office is closed, and I don't want to bother her."

Dr. Grumpy: "Good night, Syndee." (hangs up)

Overheard at the nursing station

Morning shift-change check-out:

Nurse 1: "Your patient in room 822 is going to a nursing home in 20 minutes."

Nurse 2: "Oh, good. I love to start my day with a discharge."

Surrounding nurses & doctors start snickering.

Wednesday afternoon

Mrs. Bos: "I need to find a new internist."

Dr. Grumpy: "What's up? You've been with Dr. Moonray for years?"

Mrs. Bos: "He went to some seminar on 'natural health' and now he tells me that my epilepsy is from drinking milk. He said that if I stop all dairy products, my epilepsy will cure itself, and I can quit taking Depakote."

Dr. Grumpy: "You've had epilepsy since you were a kid, haven't you?"

Mrs. Bos: "Yeah, and it runs in my family. My sister actually died a few years ago when she stopped her medications, and he says I should sue her doctor because he never discussed stopping milk with her."

Dr. Grumpy: "Wow."

Mrs. Bos: "Yeah, and when I told him that I liked and trusted you, he told me you were secretly being paid by the pharmacy and dairy companies to hide the truth about medications and milk from your patients."

Dr. Grumpy: "WHAT?!!!"

Mrs. Bos: "Yeah, that's exactly what I said."

Pause

Dr. Grumpy: "Let me give you some names..."

Rounding in the ICU

Dr. Lung: "Ibee! Do you drive a Hyundai Sonata?"

Dr. Grumpy: "No. I have an old Nissan Maxima."

Dr. Lung: "Well, someone in a Hyundai Sonata hit me in the parking lot."

Dr. Grumpy: "I'm sorry, I hope you find out who it was."

Dr. Lung: "It had to be another doctor. The Hyundai next to me has a dent that matches mine."

Dr. Grumpy: "Okay, I'm going down to ER..."

Dr. Lung: "It's going to cost a fortune to fix, too. Can you believe the way people are?"

Dr. Grumpy: "No, I'll see you later..."

Dr. Lung: "It makes you wonder whatever happened to professional courtesy when things like this happen. Maybe it was a medical student. Or a PA. Or..."

Dr. Grumpy: "I think they have to park across the street. Oh, I better take this call...Hello? This is Dr. Grumpy." (psychotically answers phone that didn't ring, walks away quickly)

I bet

Dr. Grumpy: "Any major illnesses run in your family?"

Mr. Cath: "My father had heart disease, but didn't know it until after he was dead. When his doctor told him he'd died of a heart attack, Dad was shocked."

"Hey, this Mu Shu pork tastes like..."

Yep. Not much more to say.

Thank you, Don!

Red, too

Mrs. Ganglia: "And when the headache was really bad, the right side of my face was drooping."

Dr. Grumpy: "Was it really drooping, or just feel like it was drooping?"

Mrs. Ganglia: "It was really drooping! Wait, hang on, Gary took a picture of it..."  whips out iPhone, holds it up. "Here, take a look."

On her iPhone is displayed a picture of a remarkably muscular 20-something human male, with washboard 6-pack abs, naked except for his snowboots. He's holding his erect penis in his right hand and pointing to the camera with his left.

Mrs. Ganglia: "Oh GOD! That's not it..." (swipes frantically a few times) "Here it is. You can see my face is drooping."

Dr. Grumpy: "Yes, yes, you can."

Memories...

In college I lived in a building where all the windows faced a center courtyard.

One day, when it was nice out and most people had their windows open, a couple decided to have a loud fight in the courtyard, completely oblivious to the fact that pretty much everyone in the building could hear.

I don't remember any of the details, but at some point the girl yelled: "So tell me what you want to do! If you want to break up, we'll break up! If you want to go inside and fuck, we'll go inside and fuck! Just tell me what you want!"

There was a long pause.

Then some unseen guy on the 3rd floor yelled: "Tell her you want to fuck!"

The couple looked absolutely horrified. They got in a car and left.

Candor

Mrs. Camel: "I only get migraines when I snort cocaine."

Dr. Grumpy: "Why don't you quit?"

Mrs. Camel: "Nah. I'd rather just take a headache pill."

Guilt

Dr. Grumpy: "Have you tried any pain medications for this?"

Ms. Nurse: "Well... Yeah..."

Dr. Grumpy: "What's wrong?"

Ms. Nurse: "I'm really scared to talk about it... I took something that a friend gave me. I don't have my own prescription, so I'm worried about losing my nursing license if people find out."

Dr. Grumpy: "Well, I'm not looking to get you in trouble, and to help you I need to know what you've already tried."

Ms. Nurse: "It was" (looks down) "Ibuprofen."

(pause)

Dr. Grumpy: "Did you say Ibuprofen?"

Ms. Nurse: "Yes. Oh, God, please don't report me. I know it was wrong."

Dr. Grumpy: "Um, it's over-the-counter."

Ms. Nurse: "You don't understand! This was the prescription-only 800mg! It wasn't even my prescription! I'm sorry, I can't believe I did something like that. I'm really not that kind of person!"

Dr. Grumpy: "I wouldn't worry about it."

Annual peeve

For the 4th year in a row I'm going to run this column. I'll keep running it until this practice stops. Which likely means the post will be here every damn year until I retire/die/get institutionalized.

In the past I've addressed it to the President. But since nobody (except me) running for office this year considers it to be a major issue, I'm making it the center of my campaign platform. And, if elected, I will carry it out!

Fellow citizens,

We now face a national crisis of such serious proportions that it dwarfs other issues, such as global warming, health care, and middle-east peace. It now threatens the very fabric of our society, and directly affects every citizen. And I can remain silent no longer.

It's still September, and every store near me ALREADY HAS THEIR CHRISTMAS DECORATIONS UP!

I have nothing against the holidays. Peace on Earth and all that stuff. But moving them up as if they were being held in another time-zone or alternate universe is getting out-of-hand. As far as I know, Christmas hasn't budged in my lifetime. And treating every day like it was Christmas (like the stores seem to want me to do) is not helping.

The well-respected Nick documentary program, The Fairly Oddparents, has carefully researched what would happen if Christmas were held every day (Episode 107, air date 12-12-01 I have kids, OKAY!). Their conclusion? It would be catastrophic.

There also seems to be a degree of unintentional discrimination. For example, Hanukkah starts several weeks before Christmas this year, but I don't see Hanukkah decorations going up yet. In fact, I haven't seen any at all. Or Kwanzaa stuff. Or Festivus. Or New Year's.

This seasonal perversion extends to other holidays, too. I mean, by January 2nd most stores are decked out with Easter junk, and on July 5th the Halloween crap is up.

So, if elected, I promise the following, federally mandated solutions (please note: I'm only including those holidays that retailers love. Let's face it, not many of us are out there buying gifts for Groundhog day or cards for Columbus day. I'm also leaving out local holidays like Delaware Statehood Day, the Montana Huckleberry Harvest Celebration, and the Byron, Illinois, Turkey Testicle Festival).

Valentine's Day Decorations will NOT be put up until the 3rd week of January.

St. Patrick's Day Decorations will NOT be put up until after March 1st.

Passover/Easter decorations will NOT be put up until after St. Patrick's day.

Independance day decorations (July 4th) will NOT be put up until the 3rd week of June.

Halloween stuff will NOT be put up before October 1st

Thanksgiving Stuff will NOT be put up before November 1st.

Christmas/New Year/Hanukkah/Kwanzaa/Festivus stuff will NOT be put up until the day after Thanksgiving.

(Please note: there should be some flexibility here, as Hanukkah and Easter/Passover may vary, but decorations should NOT be hung more then 3 weeks prior to holiday onset).

An alternative plan would be to have a single annual holiday combining all of the above, called St. Christmukahpasseastkwanpatfourthnewfestgivingween. Decorations for the combined holidays may be hung for 30 days prior to this event, and MUST be removed the day after.

Punishment for business owners who violate these laws would be on a 3-step basis:

1st offense: Business license revoked for one month.

2nd offense: Tarred, feathered, and forced to eat fruitcake.

3rd offense: Drawn and quartered, then served with fava beans and a nice chianti.

Yours truly,

Ibee Grumpy, M.D.

Mary's desk, September 24, 2012

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

Phone lady: "Hi, I need to make a new-patient appointment with Dr. Grumpy."

Mary: "Okay... We can see you this Friday, at 1:30. Does that work?"

Phone lady: "Yes. I have Major Illness insurance, do you take that?"

Mary: "We certainly do. We'll see you on Friday. Any other questions?"

Phone lady: "Yes, do you think I need to see a neurologist?"

Mary: "I really can't answer that. Didn't your internist refer you?"

Phone lady: "Yes, but I don't trust her medical judgment, so I'm asking you."

On call this weekend

Dr. Grumpy: "Can you move your right arm?"

Mr. Stroke: "No... The leg isn't working either."

Nurse ER: "Hang, on, I'm going to put the blood pressure cuff on you."

Dr. Grumpy: "What time did this start?"

Mr. Stroke: "About 2 hours ago."

Dr. Grumpy: "Any headache?"

Mr. Stroke: "No, but my dick itches."

Nurse ER: "Your left arm still works."

More from the artisanal mailbag

Okay, it's been a while since I bitched about the overuse of the word artisanal (see my artisanal whining page if you miss this sort of thing), so today I'm going to pick a few out from the pictures that I keep in a handcrafted folder on my computer desktop.

First we have perfume, which is likely handmade in some 3rd world chemical plant. The ad gets bonus irritant points for using handcrafted and artisan in the same sentence:

"We could fill these bottles with donkey piss, and people would still buy them. So let's do it."

This picture was sent by a reader living in China, to show that the word is now planet-wide, regardless of economic system.

"It sounds better if you use the word twice. As least that's what I think the English-as-a-2nd-language teacher said"

Next, from the United Kingdom, we have this place:

Is the trench digger artisanal? Or the power generator? Or the guy who takes your credit card when you order one?

Of course, no artisanal posting would be complete without something that grows in the dirt, was picked by someone making minimum wage, packaged by a machine, and had a label slapped on it.

Here in the U.S even a piece of paper is now artisanal:

If you're going to buy artisanal paper, you probably want a printer equal to the task:

"Handcrafted by mass-production assembly line machines in a Chinese sweatshop"

Lastly, it's important to remember that artisanal things can boldly go where no one has gone before:

"We canna go any faster, Captain! We're all out of handcrafted anti-matter!"

Thursday afternoon

Dr. Grumpy: "Have you been using anything for the shoulder pain?"

Mr. Strain: "My friend gave me a cream she bought, and I've been rubbing it on the area. I don't remember the name. It's like Ben-Gay, but gayer. I mean stronger."

Faces in the crowd

Evolution does interesting things, with unintended consequences.

Obviously, a key feature for the survival of any species is the ability to differentiate between friend and foe. If you don't recognize a predator coming toward you, or don't realize the hot girl in the cave next door is one of your own kind, you're unlikely to pass your genes on to the next generation.

As a result we're hardwired to recognize other human faces. We may have left the caves way behind us, but the basic programming is still in place, and damn near impossible to override.

Anyone recognize this picture?

How long did it take you to see a face? Likely 1 second or less.

It's an area of Mars called Cydonia, photographed by the Viking 1 probe in 1976. Scientists at the time dismissed it as a coincidence of light and shadow, but that didn't stop a number of writers (particularly Erich Von Däniken) from including it in horseshit pseudoscience. It got great publicity in non-scientific circles as "proof" of life on Mars, or as evidence that extraterrestrials had previously visited our backwater solar system.

The area in question, of course, is still on Mars, and been imaged many times since then. Here's a shot from 2000: Doesn't look much like a face anymore, huh?

This is called pareidolia, and is, in my opinion, a fascinating phenomenon.

We see faces in clouds:

In cars:

Pretty much anywhere:

Of course, with particularly famous faces, such as Jesus, Mary, or Elvis, this gets even weirder. Even before the internet age the news had occasional stories about figures (usually religious) being seen on toast, tortillas, trees, ceiling stains, and shadows on walls. With the advent of the web, however these sorts of things attract considerable attention quickly. Our continuing fascination with them is an ironic commentary on an ancient survival mechanism that keeps us from becoming something else's dinner.

It's also led to a rather bizarre cottage industry where you can now modify your toaster to put Jesus, or other famous faces, on your breakfast.

So my point here is that when you see a face on anything, whether it's bread, woodgrain, or a cloud, to just marvel at it. It's the way your fascinating brain functions to make sense out of random patterns, and keep you from becoming lion poop.

And beyond that, it's nothing.

The end.

Never mind

I'm walking a forgetful elderly lady up front after an appointment, and notice on the info sheet that today is her birthday.

Dr. Grumpy: "Happy birthday!"

Mrs. Taubeta: "Oh, is it someone's birthday?"

Dr. Grumpy: "It's your birthday."

Mrs. Taubeta: "I have a birthday coming up, too!" (looks at Mary) "Well, have a happy one!"

Mary: "It's your birthday."

Mrs. Taubeta: "Really? My birthday is next week, too! What a coincidence."

Dr. Grumpy (giving up): "Well, I hope you have a happy one."

Mrs. Taubeta: "Thank you. And to you, too. I'm sorry you have to work on your birthday."

Soap Opera

Dr. Grumpy: "Any seizures recently?"

Miss Scorned: "I don't think you've had any?"

Mr. Ictal: "Yeah, about 2 weeks ago. Remember? I was sleeping, and pissed the bed."

Miss Scorned: "I don't remember... YOU BASTARD! YOU'VE BEEN SLEEPING AT DIANA'S AGAIN!!!"

Mr. Ictal: "No! I mean, I must have been on a, uh, business trip or something..."

Miss Scorned: "YOU'RE A FUCKING GARDENER! YOU DON'T GO ON BUSINESS TRIPS!"

Mr. Ictal: "You're right, I..."

Miss Scorned: "I AM SO OUT OF HERE!" (grabs purse, leaves)

Long pause

Mr. Ictal: "So, anyway, I had one seizure, about 2 weeks ago. Hey, can you download a bus schedule? I'm going to need a ride home."

Dining out

This past Friday night Mrs. Grumpy was out with a friend. So, in the tradition of single dads everywhere, I took the kids out for a gourmet meal at Costco.

This is a surprisingly complex task that involves juggling orders for hot dogs, pizza, chicken bakes, ice cream, churros, and drinks in your head, while sending the kids on a seek-and-destroy mission to find an open table and hope they don't kill an old man eating a hot dog and hide his body under a 50 lbs. bag of dog food in the process.

I found myself in line behind a lady who was torturing the poor 16 year-old kid working the counter, and got to hear this:

Ms. Food: "I can't decide between the pizza or a hot dog."

Counter Guy: "Okay, do you want someone to go ahead of you?"

Ms. Food: "No... Which one has more calories?"

Counter Guy: "Um, not sure... I can look it up."

Ms. Food: "Well, I want something low-calorie."

Counter Guy: "Well, the salad has fewer than either of them."

Ms. Food: "Okay... I'll take a hot dog, with a piece of cheese pizza."

Happy New Year!

Wishing all a happy Rosh Hashanah.

Patient quote of the day

"When it's really dark outside, and I've closed all the window shades, and all the lights are out, then things look really dark to me. Especially if I close my eyes."