Friday, February 5, 2010

Quotable patients

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

These are not negotiations

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

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

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

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

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

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

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

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

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

And my personal favorite:

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

Thursday, February 4, 2010

Hey, who doesn't?

Dr. Grumpy: "Any other medical issues?"

Mr. Medical: "I have blood pressure."

Dr. Grumpy: High or low blood pressure?'

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

Thank heavens!

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

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

Wednesday, February 3, 2010

Attention patients!

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

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

Beats my hot tub articles

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

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

Mr. Shakes: "The obituaries."

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

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


You are a (please check only one):

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

February 3, 1959

(briefly going off my usual topics)

The day the music died.

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tuesday, February 2, 2010

Mary's Desk, February 2, 2010

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

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

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

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

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

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

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

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

Reasons to avoid cheap bras

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

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

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

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

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

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

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

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

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

Monday, February 1, 2010

Vocabulary homework

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

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

Sometimes it's fun

Seeing a sweet old lady this afternoon, named Elizabeth.


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

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

A study of ONE FREAKING PATIENT!

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

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


Termination of intractable hiccups with digital rectal massage.

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

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

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


PMID: 2299306 [PubMed - indexed for MEDLINE]
 
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