Friday, December 21, 2018

10 years

This post wraps up 2018. I'll be taking 3 weeks off, and will see you guys in January.

December 21, 2008, was, apparently, a slow news day. In looking backwards I really can't find any articles of note from the major news outlets on that date's happenings.

But to me it was a big day as I published my first post here.

A lot of factors had led up to it. For years I'd been collecting stories hoping to write a book... someday. But life, work, and kids get in the way of those things. At some point I realized the book was never going to happen.

Then, in 2008, a change in my practice led to me having a bit more free time. So, instead of a book, I decided to share my stories on this blog.

And here I am, 10 years out. My numbers have gone up and down, but I still seem to have a following. For that I'm grateful. If it wasn't for you guys there wouldn't be a reason to do this. My posts have dropped from twice daily to 2-3/week, but I'm still cranking them out and hopefully will continue to do so.

I appreciate those of you who have stayed with me and written comments. I've only been mentioned once in the general media, but knowing you guys are reading makes it worthwhile to keep doing this.

At 10 years out I want to thank my wife, for putting up with me, and my kids, who've grown from small rug rats to young adults heading for college since I started this.

I also want to thank Mary and Annie, also for putting up with me and supplying me with stories to share. Without you guys I wouldn't have a real job.

My patients deserve a big round of applause. Without them I wouldn't have this blog. Most of them are good folks, and I genuinely appreciate them making my job a fulfilling one. Medical blogs may give you the impression that most patients are insane, or stupid, or both, but that's far from true. The vast majority are good people, but stories of normal patient encounters are boring and aren't why you come here.

Lastly, I want to thank all of you guys for sticking with me over time, sharing your thoughts, and making this fun.

A special thank you is deserved by those I've met through the blog and who I'm now proud to call friends. We may never meet in person, but knowing you're out there is good enough for me.

Thank you all, have a great holiday, and I'll be back on January 14, 2019.


Thursday, December 20, 2018

2018 Holiday gift guide

Do you have a friend who's a dentist? Do you want to give your dentist something more meaningful than the gouges you leave on the arms of his exam chair? Do you know someone who simply has no sense of taste (me, for example)?

Then consider this cozy pair of pants:

Featuring an attractive pattern of molars and bicuspids in alternating red and white (I guess the color depends on whether you remembered to stop taking warfarin before your root canal), these pants are ideal for visits to the dentist, holiday parties, and any job you're hoping to get fired from.

Wednesday, December 19, 2018

2018 Holiday gift guide

Those old enough will remember Rockwell's 1980's hit "Some Random Guy is Watching Me."

Wait? That wasn't the title? Never mind.

But if you have a friend who has delusions of that sort, you can order this for them:

The "Old Asian Man Wall Decal" (seriously, that's what it's called) is available from a number of websites for people wanting to add it to their home's atmosphere. Or something.

Monday, December 17, 2018

2018 Holiday gift guide

Do you have a friend who's trying to attract the perfect guy, hoping her perfume will do the trick?

Maybe you should get her this:

Let's face it, nothing gets a guy's attention like a woman who smells like a slab of roast beef. Or an Arby's.

If nothing else, she'll certainly have the attention of every dog in the neighborhood.

Saturday, December 15, 2018

Saturday morning

Frank got home from his first college semester last night.

This morning, Mrs. Grumpy and I were woken from a sound sleep by screaming and loud noises.

Apparently, at around midnight, Frank couldn't sleep and set up his laptop to work. He'd forgotten the password for our home WiFi network. Instead of, say, waiting to ask someone in the morning, he just wiped the router and changed the passwords.

This morning the twins discovered what had happened, and went bananas when they couldn't get online. His door was locked, and when they couldn't wake him up, Marie and Craig kicked his door in.

Now Frank is upset we woke him up on his first day of break.

I'm taking the twins' side.

Friday, December 14, 2018

2018 Holiday gift guide

Do you have a friend who thinks he has animal magnetism? Maybe these boxers are the perfect gift:

Available from Newchic, this pair of boxers has a series of magnets sewn into the vital package-support area. The website makes claims about this boosting the immune system (it doesn't say if they specifically mean against STD's), "releasing energy," (if my winkie was glowing that color, I'd be pretty worried about the energy source) and (my favorite) improving the body's oxygen supply.

Plenty of guys, myself included, have been accused of thinking with our male appendages. To date, however, I've never been accused of breathing through it.

Isn't that right, Mr. Snuffleupagus?

Wednesday, December 12, 2018

2018 Holiday gift guide

Mattel, the company that brought you Barbie, Hot Wheels, Masters of the Universe, American Girl, Polly Pocket, and Matchbox, now brings you its next big seller.

And... I'm going to have to let these ladies describe it, because I couldn't possibly do a better job.

Please note, this is not a joke.

Monday, December 10, 2018

2018 Holiday gift guide

Like most medical students, you're tired. You just finished class and want to crash out on the couch. But you've also got a big test tomorrow and need to study. What can you do? Hey, I've been there myself.

You can hit the textbooks, or you can study planted on the couch if you have this human anatomy throw pillow!

What better way to get some studying done, or liven up a dinner party, than with this useful pillow cover? (Sorry, folks, the pillow isn't included).

To quote from the product description:

"Makeover and refresh your rooms with just a single touch!"

"Perfect for your home, office, playroom, kids room, cafe, study, studio, club, bar and others."

"No dye substance harming the health of you and your family."

"A perfect gift idea for your mom, dad, sister, brother, grandma, wife, husband and all other beloved ones."

"They will be shocked by the superior quality of the item when they open the present."

"We follow current trends and bring you the latest home fashion."

"A gift to your family or friend, relative or boyfriend girlfriend, or to yourself, the item should be interesting and authentic."

It most certainly is.

Thursday, December 6, 2018

2018 Holiday gift guide

Do you have a friend who needs some absolutely pointless piece of furniture? Do you have an extra $12,000 you'd like to blow?

Then this is perfect!

Why have a routine sofa that takes up horizontal floor space, when this one stands vertically?

Yes, you could take the regular sofa you already have and stand it on it's side, but what's the point? This one already does that!  Instead of getting some piece of schlock that does nothing but let people sit on it, you can have one that serves absolutely no purpose other than to say you can afford it! And isn't that what home decorating is all about?

Monday, December 3, 2018

Joe and Al

Joe and Al are both patients of mine.

They don't know each other.

They were born in the same year, a few thousand mild miles apart, speaking different languages.

To most who meet them they come across as polite older gentlemen, each with a good sense of humor. They may notice Joe's tremor or Al's speech difficulties, but neither is a major part of who they are.

But to me, they mean a lot after 20 years in practice.

Joe was born in Poland. His father was a tailor, and Joe worked in the store growing up. Because they were Jews, the family business was closed by the government so they had no way to support themselves. He saw his father beaten to death for trying to keep the family together while boarding a train. His mother was put in a different train car and never seen again. His sister was forced to work in a brothel for German officers and was never seen outside that building again. He and his brother were together until they got to the camp sorting area. His brother, who had a bad cough that week, was sent to a gas chamber. Joe was sent to do slave labor, and was still alive when the camp was liberated by allied forces. Joe, at 5'10" weighed 94 pounds by that point, and was hard to distinguish from the dead bodies he'd been forced to carry outside.

After recovering in a military hospital, Joe decided to leave Europe forever. He immigrated to America, settling in Omaha. He went to school, married, raised a family, and spent most of his life in a quiet, unassuming, desk job. Today he's nearly blind and needs a walker to get around. His wife is still at his side, and sometimes one of his kids.

Al was born in Los Angeles. He worked in a grocery store and went to high school until he turned 18, when he was drafted into the Marines.

On the morning of February 19, 1945, he was roughly 6,000 miles from L.A., in landing crafts with 60,000 other Marines, approaching the peaceful-appearing sands of Iwo Jima in the south Pacific. As they clambered ashore and gradually moved inland it was surprisingly quiet, with none of the resistance they'd encountered on previous islands.

About an hour after coming ashore, that all changed. The well-hidden Japanese forces opened up on the beach with machine guns and heavy artillery, creating a hell-on-earth. There was nowhere to hide. Al saw guys he'd had steak & eggs with a few hours earlier (the standard U.S. Marine breakfast for landing forces) collapse around him, dead. Some were wounded, and he and others tried to get them to whatever safety they could find. Then he was hit himself, but worked to help others until he blacked-out from blood loss. He woke up on a hospital ship.

After the war he returned home, finished school, and managed grocery stores until he retired. He and his wife raised a boy and 2 girls. They recently celebrated their 60th anniversary. Today he uses a walker and oxygen tank, and is nearly deaf, but still has a hearty laugh.

At this point both are in their 90's. The horrors they experienced aren't forgotten, but hidden behind a lifetime of mundanity (which, lets face it, mundanity describes most of us, and it isn't a bad thing).

In my mind they're bound together by being (most likely) the last of their kind I'll meet.

I've seen my share of Holocaust survivors, but as the years go by they've decreased, and I doubt I'll meet another after Joe.

Similarly, in 20 years I've cared for plenty of WW2 veterans, but see them grow fewer, and the odds are I won't meet another who fought at Iwo Jima.

Like many of their generation, neither wants to talk about what they went through. The memories are painful, and both men would rather be defined but what came afterwards: their families.

But they, and what they went through, shouldn't be forgotten.


Thursday, November 29, 2018

2018 Holiday gift guide

How many times have you gotten home from a long day at work, opened a cold beer, and thought, "Boy, I'm tired. I'd love to relax by putting my head in someone's ass crack."

Me neither.

Butt, if you have any friends who think this way, now there's the perfect pillow to give them!

Yes, you can relax by lying down with your head on a simulated keister. If people are always telling you that you have your head up your ass, you can now respond, "no, that's my pillow."

The website says they're "squeezable, slappable and face buriable" for those who consider these to be desirable features in tuchus-shaped bed accessories. It also notes "you can dress up your Buttress with undies and PJ's," provided you're into that sort of thing.

I understand that Mr. Arthur Frampton is coming out with a deluxe version.

Monday, November 26, 2018

2018 Holiday gift guide

Yes, as the Earth rolls around its G-type main-sequence star, we again come to the Christmakuh season. Which means it's time for DR. GRUMPY'S ANNUAL GIFT GUIDE!

This year, I'd like to start off with something for that distant acquaintance, co-worker, or friend who feels they have to hold the first party of the season, even if that means having it in July just to say they did.

What's more perfect for your friend's next party than this adorable snowman beverage dispenser?

They'll marvel when you give them this cheerful fellow to dispense refreshments from a, um, conveniently located valve. See him smile as you pull down, squeeze, and release.

Serving suggestions include spiked lemonade or Mountain Dew, though if you're a urologist you could also consider something with cranberry juice or grenadine syrup added for just the right tint.

Thursday, November 22, 2018

Thanksgiving memory re-runs

One Thanksgiving in the early-90's I was the intern on call at a local VA hospital (a veterans hospital for my non-U.S. readers, with consequently a primarily cantankerous elderly male population).

A peculiar thing about VA hospitals (at least back then, I haven't worked at one for > 25 years) is that patients could sign out at the nurse's desk to leave, then come back later to resume medical care (don't even try to understand this). So the sheet was always full of notations that patients had signed out to go to McDonald's, or buy cigarettes, or smoke, or visit friends at the homeless shelter, or hold up a liquor store, or whatever.

Some bright businessman had opened a strip club across the street from the hospital, I think it was called The Jaguar Room. So on Thanksgiving the VA ward I was covering was empty, as most of the patients had signed out to walk, wheel, or crawl over to The Jaguar Room for some female comfort and booze.

I was asleep in the intern's room when the calls began coming in, all from the bartender at The Jaguar Room. Was it safe for my patients to be smoking through their tracheostomy tubes? Were the cardiac telemetry packs still transmitting from across the street? Was there a place at the VA where patients could get more $1 bills, because they'd used them all up on the strippers?

And my favorite:

Bartender: "Can I give Mr. Veteran another beer?"

Intern Grumpy: "Um, what's the problem?"

Bartender: "He has one of those foley bags things, with the tube going up his dick. The bag is, like, REALLY full, and I'm afraid if I give him another beer it'll pop and send piss everywhere."

Intern Grumpy: "Send him back to the hospital."

Bartender: "That's bad for business."

Intern Grumpy: "So is showering your clientele with piss."

Mr. Veteran was wheeled back over to the VA immediately, by a topless stripper no less, who waited while his bag was emptied and then pushed him back to the bar.

Monday, November 19, 2018

Ebay has everything

During her appointment I was helping Mrs. Old find a better price on her pain medicine, which (of course), activated the ad-tracker software.

So a few minutes later I noticed this on a site:

Thursday, November 15, 2018

Who are the people in your neighborhood?

Dr. Grumpy: "At your last visit... let me look at the note... okay, you said you wanted to see if a massage helped your back pain, and were going to try a place near your apartment. So how'd that work?"

Ms. Lumbago: "It, um, didn't happen."

Dr. Grumpy: "Too expensive?"

Ms. Lumbago: "No... I went in there one day, and said I needed a massage, and the girl at the counter gave me a blank look. Then I realized all the girls there were in skimpy bikinis, and they had candles and soft music and a bottle of champagne out, and the counter girl said, um, 'we only take men customers' and I realized that, um... anyway I left and haven't had time to look for another place."

Monday, November 12, 2018

Seen in a chart

Knowns and unknowns, both unknown and known.

- Thank you, C!

Thursday, November 8, 2018


It's 10:55. Mrs. 11:30 walks into the waiting room, where Mr. 11:00 is reading a magazine.

Mary: "Hi, can I help you?"

Mrs. 11:30: "Yes, I have a routine appointment with Dr. Grumpy at 11:30, but my husband has a work-in with his cardiologist downstairs at 11:45, which he just made. Can I be seen early, so I can run down there?"

Mary: "I'm sorry, he's with someone now, and has an 11:00 appointment ahead of you. Otherwise I would."

Mrs: 11:30: "Can you..."

Mr. 11:00: "Hi, I don't mind waiting. I have the 11:00 appointment, so why don't you just switch us out? I don't have to be anywhere right away."

Mrs. 11:30: "Oh, thank you so much."

Mary: "Okay, that works for me. I'll let the doc know you're switching."

I finish with Mr. 10:30 and bring him up to check-out. Mary quickly explains the schedule change, so I bring Mrs. 11:30 back to my office. I address her issues, and we conclude the visit at around 11:25.

Dr. Grumpy: "All right, let me know how the medication change works out... I hope everything is okay with your husband."

Mrs. 11:30: "My husband? Why?"

Dr. Grumpy: "You said he had an urgent work-in with his cardiologist?"

Mrs. 11:30: "Oh, I just told the front people that. He's fine. I just needed to leave early because my cat sitter can't stay past 11:45."

She walked out front and left.

Monday, November 5, 2018

Texting with Frank

Also, stop calling me "Bro."

Thursday, November 1, 2018

Seen in a chart

For my non-medical readers, the last word is supposed to be "hematuria."

Monday, October 29, 2018

Annie's desk

Annie: "Dr. Grumpy's office. This is Annie."

Mrs. Daughter: "Hi, Dr. Grumpy saw my mother last week, for Alzheimer's disease. We're trying to get her long-term care approved, and need him to fill out the forms. I forget to ask him when we were there. Can I drop them by the office later today?"

Annie: "Certainly, but he's out of town this week, so won't be able to do them until he's back. We can mail or fax them back to you when ready, or you can come get them."

Mrs. Daughter: "What do you mean 'he's out of town?' "

Annie: "Family vacation stuff, his kids are off for fall break, so..."

Mrs. Daughter: "That's ridiculous. I want these forms done NOW."

Annie: "Well, he'll be back next week, so will be glad to do them then, or you can see if your mother's internist can..."

Mrs. Daughter: "The internist is the one who referred me to you. Obviously, I wouldn't have come to you if I'd known he was THAT kind of doctor!"

Annie: "Um, what kind of doctor?"

Mrs. Daughter "The kind who takes vacations when his patients need him!"

Monday, October 8, 2018

Time out

All right, gang. I'm going to have to take a few weeks off here. We're now entering the heart of the high school marching band competition season, and between my day job and band meetings, band fundraisers, band shows, band-aids, band trips, rubber bands, and band saws I need to take some time off from the blog (and a lot of other stuff, too).

See you in a few weeks!

Thursday, October 4, 2018

Breaking news!

From around the globe, Dr. Grumpy's crack team of reporters bring you the stories that shape your world.


Yeimy, a married woman, and Jesus, who she'd been having a clandestine year-long affair with, decided to call Uber for a ride to a local motel they'd booked for a romantic 30 minute getaway. The helpful Uber app noted that their driver was on his way to transport them to the love nest.

Upon arriving, they piled into the back seat of his car, only to have all parties immediately realize that the driver was actually Yeimy's husband, Leonardo, who was moonlighting that night by driving for a friend.

All parties immediately exited the vehicle.

It's unknown how many stars the driver got.


A group of thieves stole $18,000 worth of industrial-use GPS tracking devices from a tech company.

Upon discovering the loss, the company remotely switched them on and saw the majority of the devices were in a warehouse, while 2 were still being driving around in cars. Police had arrested all involved and recovered the devices within 6 hours.

Police also noted the thieves had drunk a few beers they'd found during the robbery. One of them cut himself in process, leaving bloody fingerprints behind as additional evidence.


From the "A horse walks into a bar" department.

Monday, October 1, 2018


Frank is a college freshman this year, living in a dorm. Yes, you read that correctly.

So last Thursday I'm having a typically busy day of seeing patients when a text from him crosses the top of my screen.

Frank: Dad, I need to talk to you right now. There's a big problem here.

Dr. Grumpy: I'm with a patient right now. Can it wait 15 minutes?

Frank: Yes, but hurry.

After I finished my appointment with Mrs. Freenbeen, I called Frank.

Frank: "Um, hello? Who is this?"

Dr. Grumpy: "It's Dad. You told me to call you."

Frank: "Oh, that's weird. My phone said it was a call from a doctor's office. Are you sick?"

Dr. Grumpy: "No, I'm a doctor. I work here. What's up?"

Frank: "Oh, yeah. We have an emergency. Can you, like, go to the store after work and buy, like A LOT of ant bait traps and ship them to me overnight?"

Dr. Grumpy: "What's going on?"

Frank: "Me and Mike's dorm room is, like, FULL of ants. They're everywhere."

Dr. Grumpy: "I'm pretty sure you can buy bug poison at the Target across the street from you."

Frank: "Yeah, but then I'd have to pay for it."


Dr. Grumpy: "Why don't you let the building people know about this? They can have your room sprayed."

Frank: "Mike said he'd do that... Hey, Mike, did you talk to the RA about the ants?"

(mumbling in background)

Frank: "Never mind, Dad. Mike says the RA told him they'd have it sprayed later today. Hey, why do you think we have all these ants?"

Dr. Grumpy: "When was the last time you guys took out the garbage?"

Frank: "Um... I don't think we have. But, like, we only moved in on what, August 27th? How often should we be taking it out?"

That was a month ago. WTF.

Dr. Grumpy: "I'd say at least every week, if not more."

Frank: "That's stupid. There's still plenty of room under our beds for stuff. We moved the empty fast food and pizza boxes all under Mike's bed last week, after we put the dirty cafeteria dishes and forks in the bathroom sink."


Dr. Grumpy: "Those things are what are attracting the ants!"

Frank: "Really? Why would they want that stuff?"

Thursday, September 27, 2018

History reruns - September 27, 1854

After the war of 1812 , the United States and Great Britain resumed commercial trade.

On both sides of the Atlantic, businessmen competed for their share of this increasingly lucrative business. Faster ships made more money, even if it meant going full speed into bad weather and poor visibility. Many ships vanished, forever listed as overdue, and presumed lost to bad weather and icebergs.

On the Eastern side, the driving force was Samuel Cunard. In the 1840's he came to dominate the Atlantic market, with the line that to this day bears his name. The British government backed him financially, so the ships could, in the event of conflict, be requisitioned by the navy (which they often were).

On the Western side, a number of American lines tried, with varying degrees of success. The U.S. government was less inclined to become involved in these matters, and so capital was harder to raise for building ships.

As sail gave way to steam, this changed. The Americans were concerned that Cunard's steamers could be converted to warships. Faced with both real economic and feared military competition, the government began backing various companies to try and win trade back from Cunard.

The man to lead this was Edward Collins. With government subsidies he built 4 large steamships (Arctic, Pacific, Baltic, and Atlantic), bigger, faster, and more luxurious than Cunard's ships, to challenge his rival. The plan was to run a tight schedule across the Atlantic.

The Collins Line ships, with their combination of sails and paddle wheels, were some of the fastest in the world at the time. They showed the Atlantic could be crossed in the remarkable time of 10 days, and in a few cases, 9.

Backed by their respective governments, Collins' and Cunard's lines competed intensely to dominate the 3000 miles of north Atlantic. Until 12:15 p.m. on this day.

As the Arctic steamed west, through a heavy Newfoundland fog, she collided with a small French ship, the S.S. Vesta. The Vesta, although much smaller, had a hull reinforced with iron.

In the first few minutes after the collision, many of the Vesta's crew assumed their damage was fatal, and abandoned ship (against orders) to try and reach the larger Arctic. They were wrong. The crew of the Vesta worked miracles and overcame the damage.

Captain James Luce of the Arctic was a veteran of the sea. Believing his own damage to be minimal, he turned the Arctic around to aid the Vesta, and launched 2 lifeboats to help evacuate it's passengers to the Arctic.

These orders were quickly canceled when one of the lifeboats reported the severity of the damage to him. The ship was badly damaged. Like the Titanic 58 years later, he had the legally required number of lifeboats. And they weren't nearly enough to hold everyone on board.

Cape Race was 4 hours away. With his duty to his own ship clear, Luce abandoned the Vesta, heading for land. His hope was to beach the ship before she could sink.

The wreck of the Arctic over the next few hours quickly turned into a nightmarish struggle for survival, very different from the civility seen in the Titanic. Captain Luce accepted that he and his 11 year old son (who was traveling with him) were going to die, and did his best to save passengers. He was betrayed by his crew and most of his officers.

His crew disobeyed orders, commandeered the lifeboats, and fled. A trusted officer and handpicked team of seamen were placed in a lifeboat so that passengers could be lowered down to them. As soon as they reached the water they rowed away, with plenty of space in their boat.

Without lifeboats, Luce and his few remaining crew did their best. They tore the wooden deck to pieces, frantically trying to build rafts. Doors were torn from hinges to be used for flotation. All furniture made of wood was assembled on deck in hopes of saving more lives.

Of 408 who sailed, there were 86 survivors (64 crew, and 22 passengers). Not a single woman or child lived. They're remembered by a monument in Brooklyn's Green-Wood Cemetery.

Captain Luce, surprisingly, survived. He and his son went down with the ship, but were ejected from the vortex as it sank. As they swam away, a large wooden paddle wheel cover broke loose from below the sea. It launched into the air like a rocket, then came down, killing his son. And yet, at the same time, it became a makeshift lifeboat for Luce and a handful of swimmers. They were picked up after a few days by a passing ship.

The loss was a disaster, both personally and financially, for the Collins Line. Besides Luce's son, the deaths included Collins' wife and 2 of their children.

Although mostly forgotten today, the disaster dominated headlines on both sides of the Atlantic for a month, until replaced by the Crimean War. It had the same effect then as the Titanic would in 1912. Safety specialists recommended specific East-West shipping lanes. Slower speeds and loud whistles in fog. Lifeboats for everyone. The majority of the recommendations were ignored until the aftermath of the Titanic.

2 years later, in 1856, the Arctic's sister, the S.S. Pacific, vanished en route from Liverpool to New York.

It was another blow for the Collins line. There was an economic recession, and the U.S. government was now willing to let Cunard have the Atlantic. Collins' subsidies were cut, and in 1858 his line folded. The surviving ships were auctioned off.

The wreck of the Arctic hasn't been found (to my knowledge no one has looked).

The Pacific was thought to have been lost to storms or icebergs in the north Atlantic. To the surprise of everyone, she was accidentally found in 1991 in the Irish Sea, only 60 miles from where she left Liverpool. Why she sank remains a mystery.

Cunard survives to this day, though is now owned by Carnival Lines.

Government subsidies for shipping, with the ships to be used in time of war, continued into this century in all the major powers.

The last American attempt to share the Atlantic trade lies, mostly forgotten, in Philadelphia. She is the liner S.S. United States, built with subsidies after World War II. The government paid for her huge size and (even to this day) remarkable speed, with the plan of using her as a fast troop transport in future conflicts. Her commercial career, like all liners, was doomed by the passenger jet. Multiple attempts continue to be made today to save her from the scrapyard.

Tuesday, September 25, 2018

Annie's desk

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

Mrs. Haddock: "Hi, I need a refill on my medication. It also has to be authorized through my insurance, because the last auth has expired."

Annie: "Okay, I can get started on that... you know, it looks like we haven't seen you since 2010."

Mrs. Haddock: "Wow. Time flies. Anyway, I'm going on vacation tomorrow, so can you please get this taken care of?"

Annie: "We can't refill meds on someone we haven't seen in 7 years, let alone get an insurance authorization. Who's been filling it?"

Mrs. Haddock: "My internist."

Annie: "Then you'll have to call him to get this refill, and make an appointment to re-establish with Dr. Grumpy if you want us to prescribe it."

Mrs. Haddock: "I haven't seen him in 6 months. He doesn't take my insurance anymore. It's National Illness, Inc."

Annie: "We don't take that, either, so we can't get an authorization for you."

Mrs. Haddock: "But I'm leaving TOMORROW! You need to call this in and get it authorized RIGHT NOW!"

Annie: "We can't do that, like I said, we haven't seen you in 7 years, and we're not contracted with your insurance."



Friday, September 21, 2018

The teenage mind

I'm sitting at my desk, about an hour before my first victim patient. My wife is at a meeting out of town, but fortunately the kids are old enough to drive themselves to school.

Then the text came in.

Craig: Dad. I'm locked out of the car. I need help.

What the hell? School started 20 minutes ago!

Dr. Grumpy: Ask Marie for her keys.

Craig: I can't. She's at school.

WHAT?!!! Okay, this isn't making sense.

Dr. Grumpy: Then where are you?

Craig: I'm at 7-Eleven.

Dr. Grumpy: Why are you at 7-Eleven twenty minutes after school started?

 Craig: It was an emergency! I had to get something for class! Do you have keys to the 4Runner?


Dr. Grumpy: Yes. Which 7-Eleven are you at?

Craig: The one at South Street and Central.

So I tell Mary I'm going to rescue Craig and will be back in a few. Fortunately, South & Central isn't too far from my office.

I get to South & Central, and Craig is nowhere to be seen.

Dr. Grumpy: Craig, I'm at the 7-Eleven at South & Central, and you're not here.

Craig: Well, I'm at a 7-Eleven. Maybe it's not that one.

I roll my eyes, take out my iPhone, and look up his location.

Dr. Grumpy: Craig, you're almost 3 miles away, at the 7-Eleven at 12th St. and Elm.

Craig: How was I supposed to know that? Please hurry, I'm going to get in trouble at school!

So I head over and find him there, standing outside the car. As I unlocked it he picked up two Slurpee's in a cardboard carrier and set them on the floor.

Craig: "Thanks, Dad. I'm sorry."

Dr. Grumpy: "It happens. What did you need for school, anyway?"

Craig: "The Slurpees."

Dr. Grumpy: "You left school to get 2 Slurpees? This whole thing was over a Slurpee?"

Craig: "Slurpees. I mean, yeah, Marie wanted one, too."

Dr. Grumpy: "Why didn't you get them at the 7-11 by the school?"

Craig: "I went there first, but they don't start making them until 10:00. But I remembered there was another 7-11 down here."

And he drove off.

Monday, September 17, 2018

Random pictures

Okay, time to hit the mailbag for stuff you guys have sent in:

First we have this picture, taken at an airport, where bicycles using the bathroom is, apparently, an issue:

Then there's this place's answer to "what should we get grandma for Christmas?"

"Wow! Verapamil, metformin, morphine... this place has the best gifts!"

While we're on the subject of places to get gifts, who can forget...

Then there's this product so you can "keep balling all night."

And, finally, there's this happy-go-lucky coloring book about everyone's favorite viral-disease-of-cheerfulness, RABIES.

Sunday, September 16, 2018

Holidays are coming!

So if you'd like to send in a horrifically tasteless submission for this year's Dr. Grumpy gift guide, please do so! My email is in the right sidebar.

Thank you!


Thursday, September 13, 2018


Like most neurologists, I do EMG/NCV's. This is a test that involves needles and electrical shocks.

It's nobody's idea of a fun test, but we do get a lot of information from it, and for many disorders it's the best test there is for sorting things out.

As a result, it's not uncommon for me to get a fax from another physician's office asking me to do one on a patient. They send over the insurance info and all, and Mary calls the patient to schedule it.

About a week ago I received a fax from Dr. Livingston. It was an order sheet that said "Please do EMG/NCV on Mrs. Geri, possible hand pain." Mary called her number, reached her daughter, and set up the appointment.

Mrs. Geri came in a few days later. She was in a wheelchair, pushed by her daughter. Advanced Alzheimer's disease and incapable of doing anything other than mumbling gibberish. Frail, maybe 90 pounds. Occasionally she'd randomly wave one or the other hand back and forth.

I asked her daughter why Dr. Livingston wanted the test, and her daughter told me it was because of the intermittent hand waving. She hadn't complained of pain (or pretty much anything else).

And... I couldn't do it.

Sorry, Dr. Livingston. The $250 I'd get for putting this poor old lady through an unpleasant test that she couldn't understand seemed more like an exercise in greed and torture than a diagnostic medical procedure.

Not that I really blame Dr. Livingston. I'm sure he was just trying to find out why she'd occasionally wave her hands, but to me it was immaterial. Even if I found something, after putting this sad lady through unneeded discomfort, what would really be done with that knowledge?

I explained this to the daughter and sent them on their way. The billing sheet and her insurance info went into the shredder. I took a loss on the hour and sent Dr. Livingston a polite letter explaining why I hadn't done the test.

I'm sure he can find another doctor to do it. Maybe someone hungrier than I, or less willing to ask questions.

But I just couldn't do it.

Monday, September 10, 2018

Mary's desk

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

Ms. Caller: "Hi, I'd like to make an appointment with Dr. Grumpy."

Mary: "Okay, and what will you be coming in for?"

Ms. Caller: "I have Spritzgong-Fleagle Syndrome, and need to have an MRI done annually to check for new damage."

Mary: "Okay, let's see... This week is pretty busy, but I can get you in next Thursday, at 10:15."

Ms. Caller: "That won't work. I was hoping to get in this week so I can get the MRI done soon."

Mary: "Are you having new problems?"

Ms. Caller: "No, my regular neurologist will be back from vacation next week, anyway."

Mary: "Wait... you already have a neurologist?"

Ms. Caller: "Yes, I see Dr. Stevens, at Huge University Hospital. She specializes in Spritzgong-Fleagle Syndrome, but she's on vacation until next week."

Mary: "Then... why are you calling to see Dr. Grumpy?"

Ms. Caller: "I thought he could order an MRI, then I'd have it when I see Dr. Stevens next week."

Mary: "I'm sorry, but he doesn't cover for Dr. Stevens. You'd have to call her office to get the test done, or wait until she comes back."

Ms. Caller: "Thanks for wasting my time."


Thursday, September 6, 2018


Dr. Grumpy: "How's she doing with the new medication?"

Mrs. Daughter: "Calmer, but she still treats me like a child."

Mrs. Dementia: "Are we at the doctor's yet?"

Mrs. Daughter: "Mom, this is the doctor."

Mrs. Dementia: "How do you do? This is my daughter."

Mrs. Daughter: "He's met us before, mom."

Dr. Grumpy: "How are you feeling, Barbara?"

Mrs. Dementia: "Don't talk back to me, young man!"

Mrs. Daughter: "Mom, he's the..."

Mrs. Dementia: "You don't talk back to me, either! Go to your room, right now!"

Dr. Grumpy: "Barbara, it's okay."

Mrs. Dementia: "And you're grounded, young man!"

Monday, September 3, 2018


Reminding all the guys out there that it's Prostate Cancer Awareness month. So be sure to get checked. And here's some special guests to say more.

Thursday, August 30, 2018

Wednesday afternoon

I'm in line at the bank, and hear this conversation in front of me:

Teller: "Ma'am, I'm sorry, but we can't give you a cash withdrawal without any identification."

Ms. Deceit: "How about I just get the money today? I can come back tomorrow with ID."

Teller: "No, we need a form of identification before giving you the money."

Ms. Deceit: "Like I said, I left my purse at work, or I wouldn't be here in the first place."

Teller: "Well, you can certainly get it and return later."

Ms. Deceit: "Don't be silly. For that kind of trouble I might as well go to different bank. How about if I give you my cell phone number? You can call it right now, and I'll put my phone on the counter. When it rings that will prove it's me."

Teller: "We can't accept that. What we need is a photo ID and..."

Ms. Deceit: "A photo ID is easy. Don't you have a computer back there? I'll show you my Facebook page, so then you can see my picture and know I'm telling the truth."

Teller: "Ma'am, Facebook isn't an acceptable form of identification, and we'd also need to see..."

Ms. Deceit: "This is why I prefer online banking. Places with people in them, like this, just aren't customer-friendly."

(she leaves)

Monday, August 27, 2018

Phone calls

I'm with a patient. Mary interrupts me to say there's another doctor on hold, who needs to talk to me.

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

Dr. Call: "Hi, we have a mutual patient, Mrs. Memory."

Dr. Grumpy: "Hang on, let me pull up her chart... Okay. It looks like I haven't seen her since 2014."

Dr. Call: "Okay, you need to pull her driver's license. I don't think she's safe to drive."

Dr. Grumpy: "I really can't do that after 4 years without seeing her. Why don't you have her family call Mary to bring her in? I can see her tomorrow morning at..."

Dr. Call: "That's ridiculous. She needs to have her license cancelled today. Immediately."

Dr. Grumpy: "Why don't you call the state DMV? You can do it, too."

Dr. Call: "I'm very busy! I don't have time to do things like that! This is your problem!"

Dr. Grumpy: "I..."

Dr. Call: "Okay, since you don't seem to be able to, I'll take care of it. What is the DMV phone number?"

Dr. Grumpy: "I don't know it off the top of my head, but you can..."

Dr. Call: "I'll just have my staff do it. You're not very helpful."

She hung up.

Thursday, August 23, 2018

"Stand back!"

Seen in a bladder-flow report:

Monday, August 20, 2018

All I need is a miracle

Aimovig is the first FDA-approved drug specifically developed to prevent migraines.

It’s getting a lot of press. Some articles talk about it as a breakthrough, some on how it shows the pharmaceutical industry is now focusing on migraine as a real disease, some on how it represents a new era in diseases that affect predominantly women, and many other spins.

Of course, it isn’t alone. There are 2-3 similar agents on the launch pads to join it in the next year.

From my daily office view, the phone calls (and drug reps) come in, and inevitably I hear it referred to as “the miracle drug.”

“I want to try the miracle drug.”

“I saw an ad for that miracle drug.”

“Someone at work told me about this miracle drug.”

Amgen, to their credit (not that the FDA would allow it, anyway), has NOT claimed it’s a miracle drug. The information they provide doctors is the usual glossy graphics surrounding dry statistics and obligatory legal wording. (Note - neither Amgen, nor their competitors, or anyone else, has paid me to write this post. These are my own thoughts).

People seem to need to think a drug is a miracle, in spite of all evidence to the contrary. This isn’t a slight against Aimovig - it’s human nature. Just as people thought of the Titanic as unsinkable (a claim never in reality made by her builders, owners, or officers) there’s a desire to believe human intelligence has somehow overcome a problem and cured it.

It’s not like Aimovig is the first drug to get that label, either. Botox is a miracle drug. So was Imitrex in 1992. Interleukin-2 in the 1980’s. Penicillin in the 1940’s. Willow bark in 500 B.C. (that's where Aspirin came from, people). And too many others to list.

Are these bad drugs? Far from it. But, like every other drug ever discovered, they have a lot of limitations. They work for some conditions, but not others. They ALL have side effects (if someone tries to tell you a drug or supplement doesn’t have any side effects, they’re lying). And, most importantly, humans are not a biologically identical group. No medication will work for everyone. If you read the stats on any med you’ll see that approval is based on a percentage of people who respond to it - and it’s never 100%.

There is absolutely no way to predict with 100% certainty who will - or won’t - respond to any given drug. For that matter, there’s no way to know who will - or -won’t - have side effects, or even which ones.

This is a trial-and-error crapshoot, people. We make decisions based on facts, but an educated guess is still just that - a guess.

There is no such thing as a “miracle drug. " And there never will be.

You won’t hear me, or hopefully any other reputable physician, ever tell you that a drug or surgery or whatever is guaranteed to cure you, or has no chance of harming you. Medicine is about as imperfect a science as there is.

If someone is making such a claim to you, run away. They just want your money, and don’t care about helping you.

I’m not knocking Aimovig. For some people it will be life changing. For others it won’t do a damn thing. Still others will have an unpleasant side-effect. The jury on it and its cousins is still out, and will be for at least 2-3 more years.

But don’t go into any treatment plan, for anything, thinking it’s going to be a miracle. There’s nothing wrong with being hopeful, but you can still do that and keep reality in mind. Because in this field, there are no guarantees.

Wednesday, August 15, 2018


In the mid-80's I had a medical school interview in Chicago. It ran over and finished about 45 minutes before my flight home. And the drive to the airport was around 45-60 minutes.

I went out and hailed a cab. The driver was a dude with a scruffy beard. I climbed in and asked him if he’d be able to get me there on time.

He looked at me in the rear-view mirror and said “do you mind if I smoke?”

I said no.

He lit a cigarette, mumbled “fuck” then yelled “HANG ON!” and slammed on the pedal.

I discovered my seatbelt didn’t work, but just kept my mouth shut.

I made my flight.

I gave him a good tip.

Monday, August 13, 2018

Annie's desk

Annie: "Dr. Gumpy's office, this is Annie."

Mr. Consultant: "Hi, I saw Dr. Grumpy last week, and he told me to increase my dose of Flookadook from once a day to twice a day, and it hasn't helped my symptoms at all."

Annie: "Okay, did the increase cause any side effects?"

Mr. Consultant: "No. Why would it cause side effects? I'm still taking it once a day, and haven't had any problems with it."

Annie: "But you said you increased the dose to twice a day?"

Mr. Consultant: "No, I said Dr. Grumpy told me to do that. I didn't say I had."

Annie: "So..."

Mr. Consultant: "Anyway, my symptoms aren't any better. Can you please ask Dr. Grumpy what I should do?"

Thursday, August 9, 2018

Bueller? Bueller?

Seen in a chart:

Monday, August 6, 2018

Sympathy for the devil

Please allow me to introduce myself. I’m Dr. Grumpy’s evil arch-enemy, neurological disease.

I’ve been around for a long, long year, stole many a man’s (and woman’s) soul to waste.

In the last year I’ve been in the headlines for my trifecta of stars with Parkinson’s disease: Neil Diamond, Alan Alda, and Linda Ronstadt.

The funny thing is that you people often believe life decisions or habits or activities can change your risk of meeting me. That may work for my friend heart disease, or for certain types of cancers, but me? Don’t kid yourself. Plenty of the things I do don’t have a known cause or risk factors, regardless of what some guy on the internet or TV tell you (and I bet he's trying to sell you something, too, claiming to cure it).

Others believe that a virtuous life will keep me away, or that I’m a punishment from God for being evil. You want good and evil? How about Pope John Paul II and Adolf Hitler (both Parkinson’s disease)?  You American evangelicals think you’re immune? How about Billy Graham (Normal Pressure Hydrocephalus). You think I care?

I especially love it when you try to attach political significance to me, like I’m here to punish someone on the side you disagree with. Let’s talk about Glioblastoma Multiforme, probably the most dreaded form of cancer there is. Here are 2 names from across the aisle, Ted Kennedy and John McCain. Here's another pair: Lee Atwater and Beau Biden. Political affiliations and age don't matter to me. The last pair were 40 and 46 respectively.

Before I forget, let’s talk about Alzheimer's disease: Ronald Reagan. Rita Hayworth. Charlton Heston. Glen Campbell. James Stewart. Perry Como. Jackie Fisher. Charles Bronson. Peter Falk. E.B. White. Rosa Parks. Burgess Meredith. Norman Rockwell. James Doohan. Fred Trump (yeah, his dad).

How about entertainers (besides those I mentioned above)? Slim Pickens. Gene Siskel, Ethel Merman, and George Gershwin (all Glioblastoma). Michael J. Fox, George H. W. Bush, Muhammad Ali (all Parkinson’s Disease). Terry Garr, Annette Funicello, Ann Romney, Richard Pryor, Montel Williams (all Multiple Sclerosis). Sir Laurence Olivier (dermatomyositis). Robin Williams (Lewy-Body disease). Dudley Moore (Progressive Supranuclear Palsy).

Let’s move to Amyotrophic Lateral Sclerosis, AKA Lou Gehrig’s disease or Motor Neuron Disease. This is probably the most dreaded disease in all of medicine. Obviously, Lou Gehrig and Stephen Hawking are the most well-known, but here are some other names: Mao Zedong. Catfish Hunter. David Niven. Stephen Hillenburg (creator of SpongeBob).

Epilepsy, while not usually fatal, can still have an impact on one’s life. Believed to be something to ashamed of for years, many places used to have laws on the books forbidding people with seizures from marrying or having kids. Here goes: Hugo Weaving. SCOTUS Chief Justice John Roberts. Bud Abbott. Vladimir Lenin. Neil Young. Lindsey Buckingham. Lil Wayne. Former U.S congressman Tony Coelho. Prince. Florence Griffith Joyner. Fyodor Dostoevsky. POTUS James Madison.

This list, of course, only covers famous people I’ve affected. There are far more who aren’t famous, but who are just as important. Somebody’s parent, grandparent, child, spouse, aunt, uncle, cousin, friend, co-worker, and many others. If I’ve touched them, then I’ve touched you. And you probably still remember both of us.

Years ago, I first met Dr. Grumpy when he switched from internal medicine to neurology, and I remember him telling me that it was a real shock. Back in medicine he saw mostly old people sick and dying, but in neurology it had shifted to younger folks. That discrepancy still bothers him after more than 20 years of doing this job. And it always will. He has me to thank for that.

So don’t go around making me a political, religious, age, cultural, racial, national, or whatever issue. I don’t give a crap about any of those things. I’m a human issue. If you think you’re special, and have done something that will guarantee I leave you alone, you’re wrong.

Seriously bad things, like me, can happen to you. Or anyone. Sometimes it’s just shit luck.

You don’t like that? There’s only one thing you can do. If you have some cash you don’t know what to do with, donate it to a reputable organization working to eradicate one of the diseases I’ve mentioned. Because research leads to knowledge, which leads to treatment. That’s the only way you may be able to get ahead of me.

'Cause I'm in need of some restraint.

Wednesday, August 1, 2018

Monday night, 11:18 p.m.

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

Mr. Vasculopath: "Hi, you were my neurologist at the hospital last week, when I had a stroke."

Dr. Grumpy: "Yes, what's up?"

Mr. Vasculopath: "Well, I'm really worried. You prescribed Otquoobo to keep me from having another stroke, and I read about it on It says it's really dangerous, and so I haven't started it, and now I'm worried I'm going to have another stroke, and I got all upset."

Dr. Grumpy: "Okay, let's talk about it. Are you okay right now?"

Mr. Vasculopath: "Yeah, I'm better. I just smoked a pack of cigs to calm down."

Monday, July 30, 2018

"Hey, what's that smell?"

Seen in a chart:

Wednesday, July 25, 2018

Mary's desk

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

Lady: "Hi, I need to make an appointment with Dr. Grumpy."

Mary: "Sure. What will you be coming in for?"

Lady: "I've been falling a lot - I fell today, actually - and want to get my balance checked out."

Mary: "Okay. Our next opening is Tuesday, at 3:45, then Thursday at 9:00. We also..."

Lady: "Oh, I'll need farther out then that."

Mary: "Any idea when? Like a week, or..."

Lady: "Not sure. I mean, I broke my leg when I fell today. I'm in ER, being admitted to the hospital right now. I'm supposed to have surgery tomorrow morning, so I'll be here for a few days, and then they say I'll need to go to rehab for a couple weeks."

Mary: "Why don't you just call back when you know when you'll be able to come in?"

Lady: "Am I allowed to do that?"

Mary: "Of course."

Lady: "That's a better idea. I'll do that, then."

Monday, July 23, 2018

Weekend on call

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

Nurse: "Hi, this is Susan. I'm a nurse on the 7th floor, calling in a consult on room 7147."

Dr. Grumpy: "Sure. What's the story?"

Nurse: "He's a 22 year old who took LSD a few hours ago, in the park next to the hospital, and has since been really confused. His friends brought him to ER. Dr. Newgrad wanted neurology to see him for the confusion."


Dr. Grumpy: "Are you shitting me?"

Nurse (laughing): "I wish. I tried to talk Dr. Newgrad out of the consult, and suggested we just put on some Grateful Dead in there until it wore off."

Friday, July 20, 2018

It's a guy thing

Seen in a chart:

Tuesday, July 17, 2018

Birthday gifts

One of Dr. Pissy's staff has a delightful 2 1/2 year old girl named Rachel.

This summer, due to her babysitter being on a family vacation, Rachel is at the office most days. I'm sure this irritates some people, but at our little dumpster fire of an office, we don't care. She's fun and adorable, and is a pleasant distraction from the everyday routine of medicine.

Currently Rachel is in a phase where EVERYTHING is related to her birthday, even things that are not. For example:

Dr. Pissy: "Those are nice shoes, Rachel."
Rachel: "I got them for my birthday."
Dr. Grumpy: "Is that a good corn dog, Rachel?"
Rachel: "Yes. I got it for my birthday."

Random Patient: "Is that a horse you're drawing a picture of, Rachel?"
Rachel: "It's for my birthday."

(for the record, Rachel's birthday is somewhere around Christmas)

Yesterday, I was getting ready to leave and went to get my briefcase. For some reason Rachel followed me down the hall, and I didn't hear her behind me.

I picked up my briefcase, turned around, and WHACK! my briefcase hit Rachel on the side of her forehead. It wasn't too hard, but enough to surprise and hurt her.


Her mother (and most of the front office) came charging back to see what happened. I was trying to comfort Rachel (without much success) and as soon as she saw her Mom, she ran to her.

Mom: "Rachel, did you get hurt? What happened?"

Wednesday, July 11, 2018


Actual fax received at my office:

Monday, July 9, 2018

Annie's desk

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

Mr. Tush: "I'm really not happy about this whole situation."

Annie: "Okay, what is..."

Mr. Tush: "Now they're telling me that my insurance may not cover the colonoscopy at all, and I can't afford this, so really don't want to go ahead with it."

Annie: "I think..."

Mr. Tush: "LISTEN TO ME! I'm not done yet. This is stupid. I'd never have agreed to go ahead with the colonoscopy except the doctor told me it was needed. I'm not going to pay for this and I want to cancel the whole thing. It's crazy that you people..."

Annie: "Sir..."

Mr. Tush: "NO! YOU LISTEN FOR A CHANGE. I didn't really want the colonoscopy, and now I find out it may not be covered, and..."

Annie: "LISTEN!"

Mr. Tush: "WHAT?"

Annie: "This is Dr. Grumpy's office. He doesn't do colonoscopies. You've called the wrong office."


Mr. Tush: "Well, shit. Sorry about that."


Friday, July 6, 2018

Cue the "Jeopardy" theme

Dr. Grumpy: "Do you have a medication list?"

Mr. Time: "Nope, I know everything I'm taking."

Dr. Grumpy: "Okay, what are you on?"

Mr. Time: "The first one begins with 'T' and has a lot of letters."

Wednesday, July 4, 2018

July 4, 1939

"Fans, for the past two weeks you have been reading about the bad break I got. Yet today I consider myself the luckiest man on the face of the earth. I have been in ballparks for seventeen years and have never received anything but kindness and encouragement from you fans.

Look at these grand men. Which of you wouldn’t consider it the highlight of his career just to associate with them for even one day? Sure, I’m lucky. Who wouldn’t consider it an honor to have known Jacob Ruppert? Also, the builder of baseball’s greatest empire, Ed Barrow? To have spent six years with that wonderful little fellow, Miller Huggins? Then to have spent the next nine years with that outstanding leader, that smart student of psychology, the best manager in baseball today, Joe McCarthy? Sure, I'm lucky.

When the New York Giants, a team you would give your right arm to beat, and vice versa, sends you a gift — that’s something. When everybody down to the groundskeepers and those boys in white coats remember you with trophies — that’s something. When you have a wonderful mother-in-law who takes sides with you in squabbles with her own daughter — that's something. When you have a father and a mother who work all their lives so that you can have an education and build your body — it's a blessing. When you have a wife who has been a tower of strength and shown more courage than you dreamed existed — that's the finest I know.

So I close in saying that I might have been given a bad break, but I've got an awful lot to live for. Thank you."

-Lou Gehrig, terminally ill at age 36 with ALS (aka Motor Neuron Disease), in his retirement speech. He died less than 2 years later.

This is likely the worst disease in neurology, if not all of medicine. It's been 200 years since the first published report on it, and effective treatment remains a mystery.

If you're looking for a cause to give money to, consider the ALS Association.

Friday, June 29, 2018

Random pictures

All right, time to hit the mailbag for stuff you guys have sent in.

First we have this delightful hand lotion:

Then we have this playground equipment, apparently designed prior to Copernicus, or the discovery of the sun for that matter:

Here's a "trending" news item, apparently created by a random word generator in Wisconsin:

Here's a mystery question that a reader says was part of her on-line medical license renewal:

Then there was this guide to grilling that could have used an extra word:

Wednesday, June 27, 2018

Seen in a chart

Monday, June 25, 2018

The Master

In the 1980's Mojo Nixon claimed "Elvis is Everywhere." While anyone who visits Vegas might concur, I have to disagree.

Here, at Grumpy Neurology, Yoda is everywhere.

Sure, he may be in many disguises, but even a Jedi Master can't hide that characteristic language pattern from a trained DoC* like me.

The following are quotes I've encountered:

From patients:

"Twenty-one headaches I had in May. Many migraines that is."

"Make the seizures stop, can you?"

"I tried to talk, but speech-wise, I could not." 

"Much pain my back does have."

"Forgot you also this, Topamax, work it did not."

In an MRI report:

"Nothing abnormal does the MRI show."

From a nurse:

"Ativan received at 8:00, she did."

From a drug rep:

"Reduction in pain they will have, yes."

From my secretary:

"3:15 tomorrow his appointment is."

And (my favorite) was this patient interaction:

Dr. Grumpy: "You really need to stop overusing Excedrin."

Lady Rebound: "It's hard, but I'll try."

Mr. Rebound: "No! Do... or do not. There is no try."

*Disciple of Charcot

Wednesday, June 20, 2018

Blood pressure and other things

Mrs. Methodical: "My blood pressures have been good, too."

Dr. Grumpy: "I'm glad. What have they been running?"

Mrs. Methodical: "I have a list in my purse. Would you like to see it?"

Dr. Grumpy: "Certainly."

She rummaged in her purse for a minute, then handed me this:

Monday, June 18, 2018


Dr. Grumpy: "Any side effects with the new pill?"

Mr. P: "Only one, it makes my urine smell like something terrible."

Dr. Grumpy: "Okay and what about..."

Mr. P: "I brought some, in case you want to smell it."

Pulls Tupperware container out of bag.

Monday, May 28, 2018

That's a wrap, folks

With the school year down to it's final 2 weeks, I'm shutting down the blog until the shouting here is over. Too much band stuff, year-end competitions, parties, and other stuff to deal with, besides my day job.

See you in a few weeks!

Friday, May 25, 2018

Texting with Frank

Mrs. Grumpy asked me to deal with dinner. Not knowing what the food status was at home, I made the mistake of asking Frank for help.

Some days... Sigh.

Wednesday, May 23, 2018


Mrs. Whiney was not happy.

She'd shown up 45 minutes late for her new patient appointment with no other explanation than "I have other things to do too, you know!"

Now she was not accepting that I wasn't going to see her and she'd have to reschedule for the next available slot, 2 weeks from now (and I thought I was being nice by letting her do that).

She'd berated Pissy's staff, who'd gotten Mary.

She'd been chewing out Mary, who'd finally walked away from the window and called me out from a patient room.

She was absolutely stunned when I told her I agreed with Mary, and she wasn't going to be seen today.

In an attempt to get me to give in she menacingly said "I. Want. You. To. Know. That. I'm. Calling. Dr. Stevens. And. Telling. Him. You. Treat. His. Patients. Like. This."

I smiled and wished her a good day. She pulled out her phone, knocked on the window, and asked if we could give her Dr. Steven's phone number. We ignored her.

Now it was time for her to make a scene for the rest of the lobby. And she made the critical mistake of getting her phone involved.

Mrs. Whiney: "Siri! Call Dr. Stevens!”

Siri: “There is no Dr. Stevens in your contact list.”


Siri: “Now playing 'Right Here Right Now' by Jesus Jones." (music starts)

Some elderly guy in my lobby and the drug rep he's never met before next to him start holding each other to keep from cracking up.


Siri: “There is a chiropractor 1/2 mile north of you. Would you like directions?"

Drug rep starts snorting loudly and runs out of office, mumbling something about allergies.

Mrs. Whiney: “SIRI! CALL DR. STEVENS!”

Siri: “I found 3 pharmacies within two miles. Would you like me to call one of them?"

Mrs. Whiney throws her phone on the ground, picks it up, shoves it in her purse and yells "IT"S NOT FUNNY!" She storms out.

A few seconds passed before everyone in the office and lobby completely lost it and became hysterical. Including the patient who'd wandered out of my office to see why I hadn't returned.

Monday, May 21, 2018


Dr. Grumpy: "How's the new medication working out for you?"

Mr. Pill: "Terrible! I'm nauseous all the time, have headaches, and throw up a lot!"

Dr. Grumpy: "Then let's stop it and..."

Mr. Pill: "I don't want to do that! I just bought a 90 day supply!"

Thursday, May 17, 2018


As the school year begins wrapping up, we're moving into the next phase of the Wingnut High School marching band schedule: preparing for next season's football halftime show.

Yeah, you read that right. The next high school football season starts in 3-4 months, and so the twins and their friends are already working on the show.

So yesterday a flyer was sent home with the twins, listing all the stuff. Band camp dates. Meetings over the summer to start working on props. The theme of the show. Where to find the music to practice. Marching formations. Color guard maneuvers. Incoming freshmen orientation. Yadda yadda yadda.

About halfway down the page Mrs. Grumpy and I were surprised to find a paragraph that said “Practice marching sessions for the new steps and formations will be June 19, 25, and 29, July 7, 14, and 22, and August 12, 18, and 22. These will be held at Craig Grumpy’s house from 10 a.m. to 2 p.m. Bring your own water bottle. Lunch will be provided.”


Monday, May 14, 2018


Dr. Grumpy: "Are you much of a drinker?"

Mr. Collins: "Nope. Not at all. Just coffee, but I admit I'm a caffeine junkie. I drink it all day."

Mrs. Collins: "What are you talking about? You put Baileys in your coffee all day! You even keep it in that little thermos you sneak to work!"

Mr. Collins: "That doesn't count!"

Wednesday, May 9, 2018

Seen in a chart

Remember medical students: taking a good family history now includes covering test conclusions, free text, and practice management, but fortunately not retardation or cancer.

Monday, May 7, 2018

Random pictures

Okay, time to hit the mailbag for stuff you guys have sent in.

First, taken in a subway, is this opportunity that could end unemployment:


Here's this headline, which is just begging for someone to snicker at it.

Then there's this refrigerator drawer in a reader's recent appliance purchase, which sounds somewhat obscene:

 Here's a coffee pot seen early one morning at a hospital nurses station:

That's an interesting name for your iPhone:

And, finally, this box label. Which seems awfully pretentious for a freakin' cantaloupe.

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