Monday, June 17, 2024

"Helluva diuresis, eh?"

One of my patients landed in the hospital overnight for mild pneumonia, and his wife asked me to look at the records to make sure there weren't any changes in his Parkinson's medications.

In the discharge summary I noticed this:


 



Thursday, June 6, 2024

June 6, 1944

"There have only been a handful of days since the beginning of time on which the direction the world was taking has been changed in one 24-hour period by an act of man. June 6, 1944, was one of them.

"No one can tell the whole story of D-Day. Each of the 60,000 men who waded ashore that day knew a little part of the story too well. To them the landing looked like a catastrophe. Each knew a friend shot through the throat, shot through the knee. Each knew the first names of five hanging dead on the barbed wire offshore, three who lay unattended on the beach as the blood drained from the holes in their bodies. They knew whole tank crews who drowned when their tanks were unloaded in 20 feet of water.

"There were heroes here no one will ever know because they're dead. The heroism of others is known only to themselves.

"What the Americans and the British and the Canadians were trying to do was get back a whole continent that had been taken from its rightful owners. It was one of the most monumentally unselfish things one group of people ever did for another.

"It's hard for anyone who's been in a war to describe the terror of it to anyone who hasn't. How would anyone know that John Lacey died in that clump of weeds by the wagon path as he looked to his left towards Simpson and caught a bullet behind the ear? And if there had been a picture of it - and there weren't any - it would've shown that Lacey was the only one who carried apples for the guys in his raincoat pocket.

"If you think the world is rotten, go to the cemetery at Saint-Laurent-sur-Mer on the hill overlooking the beach. See what one group of men did for another, D-Day, June 6, 1944."

- Andrew Rooney (1919-2011)

Monday, May 27, 2024

I'm not following this

 Seen in a chart:

 


 

Monday, May 20, 2024

Quiz time

Okay, as required to maintain my hospital privileges (in addition to sending in a check) every 2 years I have to take mandatory online testing to make sure I can deal with situations at the hospital.

So, without further comment (that's your job, isn't it?) here are some of the questions I was asked, along with the answer options:

 








Wednesday, May 8, 2024

Here

LOOK, PEOPLE! JUST BECAUSE LADY GAGA IS ADVERTISING FOR A MEDICATION DOESN'T MEAN SHE'S GOING TO PAY FOR YOURS IF YOUR INSURANCE WON'T!

Monday, April 29, 2024

Waiting list

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

Ms. Frantic: "Hi! I really need to see a neurologist! All the ones at Massive Clinic are booked out to July, so I was hoping your office might have something sooner."

Mary: "Actually, you're in luck. We just had a cancellation for tomorrow, so Dr. Grumpy can see you at 10:00 in the morning if that works."

Ms. Frantic: "Dr. Grumpy has an opening for tomorrow?"

Mary: "Yes, would you like it?"

Ms. Frantic:" Um... no. Honestly, if your doctor isn't booked out, than he probably isn't very good. I'll just wait for July."

Sunday, April 14, 2024

Detective stories

Did anyone else out there read "The Problem of Cell 13" by Jacques Futrelle?

I'm assuming I'm not the only one, as it was in the standard 6th-grade reading textbook my generic public school used in the early 1970's.

It was one of several early 1900's detective stories by Futrelle featuring his character Augustus S. F. X. Van Dusen (AKA The Thinking Machine), a reserved, brilliant, scientist who solved problems solely by logic (kind of a 1905 Mr. Spock). Almost 100 years later Van Dusen also appeared in the comic book series "The League of Extraordinary Gentlemen."

"The Problem of Cell 13" featured Van Dusen being voluntarily incarcerated in a high-security prison to prove that, by thinking, he could figure a way out and escape within a week - which he did. Probably Futrelle's most well-known story, it's since been adapted, both in whole and in part, several times for TV and radio. Most recently was in 2019 for an episode of the NBC TV series "The Blacklist."

For whatever reason it was a handful of stories I read growing up that I never forgot ("The Long Sheet" by William Sansom was another) and when the internet age dawned the story was long in the public domain and easy for me to find.

The writer, Jacques Futrelle started as a journalist. He began the sports section for the Atlanta Post, then was hired by the New York Herald where he covered the Spanish-American War. Afterwards he worked in Boston, then left journalism to become a full-time, and successful, detective writer.

His wife, Lily May Futrelle, was also a prominent author. She wrote for the Saturday Evening Post. Her first novel "The Secretary of Frivolous Affairs" was on the U.S. bestseller list from 1911 to 1915 and made into an early silent film (one of the first movies written by a woman).

Besides raising a son & daughter, and their separate writing careers, they collaborated on a Van Dusen story, "The Grinning God," in which she wrote the first half of the mystery to set the stage and he wrote the second half, with Van Dusen solving it.

They both did well as authors, allowing them to build a coastal home in Scituate, Massachusetts and enjoy the newfangled luxury of an automobile.

In early 1912 they left the kids with his parents and headed to Europe for 2-3 months to promote their books. The trip was successful, to the extent that they were given a complimentary first class suite by a shipping line for the journey home.

 


 

112 years ago tonight, the Futrelles stood together on the sloping decks of the Titanic.

Offered a chance to get in a lifeboat with her, he refused, and insisted the space be given to another woman.

After returning home, she wrote a 2-part piece on the disaster for the Boston Post, published on April 21-22:

 

"The last I saw of my husband he was standing beside Colonel Astor. He had a cigarette in his mouth. As I watched him, he lighted a match and held it in his cupped hands before his face. By its light I could see his eyes roam anxiously out over the water. Then he dropped his head toward his hands and lighted his cigarette. I saw Colonel Astor turn toward Jacques and a second later Jacques handed the colonel his cigarette box. The colonel screened Jacques' hands with his own, and their faces stood out together as the match flared at the cigarette tip. I know those hands never trembled. This was not an act of bravado. Both men must have realized that they must die."

 

His body was never recovered. He was 37.

Lily May never remarried. She raised their children, published her own novels, completed & published those Jacques hadn't, taught writing clinics, and hosted radio shows. In 1940 she spearheaded efforts to extend authors' copyrights for an additional 28 years, which was signed into law by President Roosevelt. She was given the pen that he used.

Every year, on the anniversary of the sinking, she walked from their home to the seafront to cast flowers in for Jacques.

She died in 1967.

Monday, April 8, 2024

Inside Job

A long time ago, when I was first starting out, I worked at a hospital that had only one MRI-compatible ventilator.

For my non-medical readers, a ventilator is the "breathing machine" that keeps you alive when your body needs a break, during surgery, etc.  Once you're better we take you off it. It's a very complicated gadget, with a fair amount of ferrous metal.

As a result, a standard ventilator can't go in an MRI. Since patients on one sometimes need an MRI (usually once a pesky neurologist gets involved) there are MRI-safe ventilators. These are stripped down machines, mostly plastic and non-ferrous metal. They're less durable than a regular ventilator and don't have all the features, but they're fine for an hour or so that a patient needs it while in the MRI machine.

Anyway, back at Small Hospital, one day the MRI-safe ventilator was missing. This was a real problem, because now we couldn't do MRI's on ICU patients who needed them. We were able to temporarily get an extra from a larger hospital across town, but still needed ours back. They ain't cheap.

Security searched, literally, every square inch of Small Hospital. The kitchens, the bathrooms, every patient room, the storage areas... it wasn't there. Small Hospital didn't have the array of video monitoring they do now, so looking for someone leaving with it wasn't possible.

One early morning during rounds I was in ICU, chatting about it with some of the nurses when one of them said, half-joking, "maybe it's on Ebay."

Since I was on the computer looking up labs, I switched over to Ebay... and there it was. A used MRI-compatible ventilator, same model, which had been up for sale since one day after it had gone missing. The seller's name was an easily-recognizable variant on the name of a guy who worked as a hospital radiology transporter.

The ventilator was back a few day later.

The transporter spent some time as a guest of the state, in spite of his clever defense that he'd seen it standing next to a dumpster at his apartment complex several miles from the hospital and had just kept it as a decoration because he didn't know what it was but it looked cool.

The machine was at the hospital for several more years before it was replaced by a newer model. For the rest of its service the nurses kept a sign on it that said "NOT FOR DECORATION."

Monday, April 1, 2024

Doctors behaving badly

I'm with a patient when Mary wanders back.

Mary: "Hey, Dr. Hypothec is on line two, he asked me to interrupt you."

Dr. Grumpy: "Okay. Hang on, Mrs. Fonebone, let me get this... Hi, this is Dr. Grumpy."

Dr. Hypothec: "Hi, this is Mort Hypothec across the street. Thank you for taking my call."

Dr. Grumpy: "What's up?"

Dr. Hypothec: "I had a a question about my wife, did you ever see her as a patient?"

Dr. Grumpy: "Not that a recall."

Dr. Hypothec: "Well, she works in mortgages, and was wondering if you were interested in refinancing your home? She can get you an excellent rate."

Monday, March 25, 2024

Seen in a chart


 

Tuesday, March 19, 2024

Happy Springtime!

(or Autumn, if you're on that side of the planet).

My favorite ode to spring, courtesy of the great Tom Lehrer:

Spring is hereSpring is hereLife is skittles and life is beerI think the loveliest timeOf the year is the springI do, don't you? 'Course you doBut there's one thingThat makes spring complete for meAnd makes every SundayA treat for me
All the world seems in tuneOn a spring afternoonWhen we're poisoning pigeons in the parkEvery Sunday you'll seeMy sweetheart and meAs we poison the pigeons in the park
When they see us comingThe birdies all try and hideBut they still go for peanutsWhen coated with cyanideThe sun's shining brightEverything seems all rightWhen we're poisoning pigeons in the park
We've gained notorietyAnd caused much anxietyIn the Audubon SocietyWith our gamesThey call it impietyAnd lack of proprietyAnd quite a varietyOf unpleasant namesBut it's not against any religionTo want to dispose of a pigeon
So if Sunday you're freeWhy don't you come with meAnd we'll poison the pigeons in the parkAnd maybe we'll doIn a squirrel or twoWhile we're poisoning pigeons in the park
We'll murder them allAmid laughter and merrimentExcept for the fewWe take home to experimentMy pulse will be quickenin'With each drop of strychnineWe feed to a pigeon(It just takes a smidgin!)To poison a pigeon in the park

Monday, March 18, 2024

Semantics

 "What do you mean the drug doesn't work? We can't write that! Find a better way to say it!"



Thursday, March 14, 2024

Happy Pi Day!

In honor of Pi Day, AKA Einstein's birthday...

 

Hi, this is Craig Grumpy.

A few years back, you may remember, I worked at Local Grocery's bakery.

One of my co-workers there (besides my sister) was Josie.

Josie was no pussycat, but was good at her job, except for the whole dealing-with-customers bit. Polite conversation was not one of her strong points. Because she was otherwise a good employee management tended to overlook this, and the rest of us tried to deal with people and let Josie do her thing in the back, mixing dough, baking stuff, decorating cakes, etc.

Unfortunately, this wasn't always possible, and there was an afternoon where she and I were the only ones on. She was out putting bagels on the shelves and I was leaning into the donut case, cleaning it for the next morning. So I didn't see a lady walk past a large display that said "PIES," and head for Josie... until it was too late.

Lady: "Excuse me! Where are the pies?"

Josie: "Uh, over there, behind you, on the left."

Lady: "Thank you."

The lady went over and began carefully inspecting the pies that were out. I turned back to the donut trays, glad that it had been straightforward.

In the meantime the lady was going through the pies, carefully reading each box (these are generic supermarket pies, folks). After a minute I realized she'd followed Josie back to the bakery counter and it was too late for me to run interference.

Lady: "Excuse me again!"

Josie: "Yes?"

Lady: "I was looking at your pies. Do you have any that are sugar free and gluten free?"

Long pause.

Josie: "Ma'am, this is a bakery."

Josie disappeared into the back.

Sunday, March 3, 2024

Sigh

Look, calling my phone every 2 hours all weekend is NOT going to make your lab results come any faster.

Monday, February 26, 2024

You go, dude

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

Dr. Hyper: "HI! THIS IS MIKE HYPER! I'M THE HOSPITALIST ON CALL OVER NIGHT, AND I NEED YOU TO HAVE A LOOK AT A GUY I THINK MAY HAVE HAD A SEIZURE! HE FAINTED OVER AT THE HOCKEY ARENA!"

Dr. Grumpy: "Okay, I'll swing by in the morning."

Dr. Hyper: "THAT SOUNDS GREAT! HANG ON, LET ME JUST GET MORE COFFEE HERE... ANYWAY, HE BIT HIS TONGUE, BUT DOESN'T HAVE ANY HISTORY OF SEIZURES!"

Dr. Grumpy: "Was he incontinent?"

Dr. Hyper: "HE CERTAINLY WAS! IN FACT, I CHECKED HIS PANTS MYSELF!"

Sunday, February 18, 2024

Sunday afternoon

My current hospital consult is apparently unable to finish any sentence without putting the word "diarrhea" into it somewhere.

Friday, February 9, 2024

Quote of the day

 "I have insomnia, but it's only a problem when I'm trying to sleep."

Monday, February 5, 2024

Seen in charts

Here's some things you guys have sent in that somehow made it into medical records. Just remember folks, somewhere out there your doctor may be the culprit.


First, from the "wait, what?" department is this unusual treatment for anxiety:

 

"I guess it depends on what's making you anxious, nudge nudge wink wink"


From the "I'd like to buy a vowel" category cums comes this gem:

"I guess that's nudge nudge wink wink again"



From the case files of Captain Obvious, M.D. we have these notes:

and

 


 

And, lastly is this note from the "How lazy can you get?" department:

 

This brings back memories from when I worked at the VA 30 years ago. A patient would come to the floor, and the admitting note said "Past history: see old chart." The old chart was inevitably at least 5 volumes, each one 3-4 inches thick.



Monday, January 22, 2024

Random pictures

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


First off, we have this label from a home sander:




Next is this, from the insanely long line for Radiator Springs Racers at Disneyland:

"That's tongue in cheek... I didn't mean it that way."


In a tribute to capitalism, I have to respect the location of this cookie store:



Love these stupid ads. Here's a tip: don't try to sleep in the surf. Was this Harold Holt's idea?

 
 
 
 
Lastly, since we're on the subject of things to help you sleep, Netflix wants to play "one of these things is not like the others."





Monday, January 15, 2024

Modern technology

After having one for a few months, I highly recommend the Amazon Ring to anyone who's ever wanted to see regular pictures of themselves, in pajamas and a robe, carrying out the trash.

Friday, January 12, 2024

Kill me

Currently trapped in line at a pharmacy behind a woman demanding generic Emgality and refusing to leave until she gets it. So I guess I'll be here until 2034.

Monday, January 8, 2024

Memories

Dr. Hurricane was an attending where I trained.

He was one of these people who lived at warp speed. While he was a good teacher, and had an excellent fund of general neurology knowledge, it was all limited by his frenetic manic speaking style of rattling off facts, statistics, and teaching points at an insanely high speed on rounds. In fact, he reminded us of John Moschitta, the star of FedEx commercials in the 1980's.







Yeah, and that was what Dr. Hurricane sounded like on a slow day.

I carried a clipboard and notebook with me on rounds, and would frantically, if unsuccessfully, try to keep up with his teaching points. This only resulted in severe hand cramps and my notebook bursting into flames.

Another resident, Karl, made the immortal comment that "Dr. Hurricane doesn't talk. He has lip fasciculations."

In clinic, patients were terrified of him. Not for him actually being threatening, but for his ability to rapidly give them the entire diagnosis and treatment plan in about 10 seconds, at a speaking frequency far beyond the ability of others to discriminate individual words. Dr. Hurricane blew into the room, Dr. Hurricane blew out of the room, leaving a prescription behind, fluttering gently in the breeze.

And, of course, I (the resident) was left standing there as the patients asked "what did he just say?"

Damned if I knew. Their guess was as good as mine.

 

 
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