I'll miss you, Lady

Patients die. It's part of life and medical practice.

But last week one of my favorite patients died, and I'll miss her.

Due to shit luck she's been in a wheelchair for the last 15 years with a serious neurological disease. It made her suffer constantly from pain. When a freak accident cost her an eye 10 years ago, she accepted it as the crap it was, and went on with her life. She never once filed for disability. And in spite of this she was always cheerful.

I saw her every few months. Not that I really had much to offer her, but she came in to see if anything new was out. And when I said no, she accepted it with grace. I told her she didn't need to come back for a year, but she'd always be back sooner. Over the years our appointments became as much social visits as they were medical. So we'd chat about shoes and ships and ceiling wax.

She knew about this blog, one of a handful of patients who does. She'd been through so many doctors and tests and treatments that she loved to laugh at the insanity of modern medicine. She'd always joke with me that she was looking for herself on it, but I told her she'd never given me anything to write about.

And so it seems fitting, that, in dying, she finally ended up here.

She went to Local Hospital ER for pain 2 nights ago, and they sent her for a CT scan. While in the machine, she died. The code team worked on her for an hour in radiology, and couldn't get her back.

I learned of her death yesterday, and went over to read the chart, to see what happened. I was reading through the Code Blue note. Which ended with this line:

"After being pronounced dead, the patient was returned to ER for further evaluation and treatment."

Good night, Lady, wherever you are.

Attention patients!

The emergency room is for EMERGENCIES!!!

I'm sorry if you're frantic to have your test results back from Local MRI, but going to the ER, hoping that maybe they'll be able to get them faster for you, for the same damn symptoms you saw me for 2 days ago in my office, is an absolute waste of everyone's time and money, including YOURS.

In fact, we'd already left a message on your answering machine AND voice mail that the test was fine (surprisingly, it even showed a brain), but you'd already gone to the ER for this incredibly stupid reason, and had turned off your cell phone when you got there.

Minor difference.

I'd like to thank my reader Dr. Phil, for submitting this to show me that my office isn't alone.

Receptionist: "Dr. Phil's office. What can I do for you?"

Mr. Gloom: "I need to make an appointment."

Receptionist: "Okay... Is it to see the doctor? Or to have blood drawn?"

Mr. Gloom: "To draw blood. I need to have labs done before my autopsy."

Receptionist: (looking through the schedule) "Umm... You mean your biopsy?"

Mr. Gloom: "Yeah, whatever it's called."

I think they ablated your cortex

Dr. Grumpy: "Have you ever had any surgeries?"

Mrs. Dimbulb: "I had a girl-part ablation. It was like an ovarian ablation, or uterine ablation, or vagina ablation. Something like that. Maybe they ablated my hysterectomy?"

Dr. Grumpy: "Umm..."

Mrs. Dimbulb: "Hey, what does ablation mean, anyway?"

Attention crooks!

I'd like to thank my reader Cindy for submitting this.

Basically, gang, if you're pathetic enough to be a purse snatcher, please keep in mind that you should NOT stop to count your money in front of a police station.

Just a tip.


Cops: Robber stopped to count loot outside police station

From www.chicagobreakingnews.com
June 9, 2010 4:14 PM

A suspect almost got away after snatching a purse at a Pink Line station and running off this morning.

But then he stopped to count the money. Just outside a Chicago police station.

A witness who had been following the suspect alerted officers inside the police station at and the robber was arrested after a brief chase.

"I guess it never dawned on him that it was a police station," said Ogden District Lt. Ken Sahnas.
The man allegedly robbed the woman at the Kedzie Avenue CTA station near 19th Street and Kedzie Avenue about 10:30 a.m. as he was getting off a train. The robber fell down the stairs as he was being chased by the woman, who had also been on the train, police said.

The witness, Munchie Wade, said he was waiting for a bus outside the train station when he heard footsteps on the stairs and saw the robber fall.

To read the rest of the story, click here.

"Hey! Why doesn't this floor have call lights?"

Mr. Stemi: "When I had my heart attack I was on the telepathy floor for a week."

Dr. Grumpy: "You mean the telemetry floor."

Mr. Stemi: "Yeah, whatever it's called."

Your researchers at work: hockey surprise

I'd like to thank my reader NLK for submitting this.

Okay, gang. The reputable Journal of the American Medical Association has apparently decided to demonstrate that idiotic research is done not only in the U.S. (and Haifa, but that's a city, not a country) but also by our friendly neighbors to the north.

Yes, a team of Canadian researchers has made the stunning discovery that hockey players who give and receive body checks during a game are more likely to suffer serious injuries than hockey players who don't.

I am not making this up.

The original article, if you must read it yourself, is:


Risk of Injury Associated With Body Checking Among Youth Ice Hockey Players

JAMA. 2010;303(22):2265-2272.

Dear Mrs. Frosting,

Congratulations on your first wedding anniversary!

I know a lot of people save a layer from their wedding cake, to eat on the first anniversary. I have no problem with that (I don't remember anymore if we did or not, but if I ask Mrs. Grumpy she'll kill me for forgetting that important point).

Anyway, I'm sorry the cake was so badly freezer-burned that it was inedible. Sometimes that happens. I'm sure you were disappointed at having to throw it out.

Apparently, though, you couldn't bring yourself to do that. So why on Earth you decided to dump it off at my office as "treats for the staff" I have no idea. I can only assume you don't have neighbors or co-workers that you hate enough to give it to.

Mary and Annie have put your thoughtful wedding souvenir in an appropriate place. If the Audobon society calls tomorrow asking about a large number of dead pigeons near our dumpster, we're giving them your name.

Monday afternoon goes to hell

Sorry, guys, today was a disaster. Due to a problem in my office building, I had no internet at all. They tell me it may not be up tomorrow, either. Anyway, I apologize for not being able to put up your comments or post today's insanity earlier. But Grumpy Neurology, P.C. had temporarily been reduced to Screaming Obscenities into the phone at the ISP Neurology, P.C. instead.


Dr. Grumpy: "So we got you a wrist brace, and you went to physical therapy for the carpal tunnel syndrome. How's it been going?"

Mr. Mano: "Better. The therapy place is good. The staff there did a really good hand job. Um, I mean, job on my hand, because it felt really good and... Doc, that doesn't sound good, does it?"

Dr. Grumpy: "No, but I think I understand what you mean."



15% off cherokee workwear with code "workwear_r2d"

Jobs

Like most doctors, I get boatloads of job offers. Tons. Every freaking day in the mail.

"Great Opportunity! Live in scenic Nofuckingwhere! Incredible Salary!"And they always have pictures of stunningly attractive men and women, with amazingly cute children, doing outdoor activities. Or attending the theater. Or doing anything but wading through a huge pile of charts with a lobby full of patients. They make the jobs sound so wonderful that you wonder why the previous doc left.

These things have all sorts of catchphrases about remarkable salary, fast-track to partnership, limited call, great public schools, outdoor activities, cultural events, etc. Usually it runs something like this: "Practice in a beautiful area, where you can live 5 minutes from the beach, mountains, and international opera house. World class schools in an area with absolutely no crime, drug problems, or pesticides. Enjoy year-round skiing, golf, wind-surfing, fishing, kayaking, and snowboarding. Call schedule is 1 in 365, with no hospital coverage. Earn $175 billion dollars a year and a generous program to help you pay back your med school loans, with a fast-track to partnership."

So, as a courtesy to other medical professionals, I've waded through these things and collected the most commonly used phrases, and now offer a translation:

"World Class Medicine": (which world? Neptune?)

"Directorship position": You're the only doc for 500 miles.

"Practice without limits": Patients will push the envelope like you wouldn't believe.

"Short drive from recreational opportunities": Not that you'll ever have time to go, but you can drop the kids off on your way to work.

"Theater events": The high school kids put on "Li'l Abner" in the fall.

"Low Crime rates": Everyone has a gun, and shoots on sight.

"Invigorating river nearby": We're downstream from a sewage plant.

"Unique patients": Inbred families with webbed fingers.

"Fine shopping": We have a Walmart AND a Target!

"Fine local cuisine": Whoppers, Big Macs, AND Wendy's"

"Wholesome community": Minorities kept out at gun point.

"Join a growing practice": You're it.

"Moving bonus": Biff will come help you unload your truck

"University town": ER is full of drunken fratboys.

"Physician-friendly hospital administration": And you can see Bigfoot here, too. Pigs also fly.

"Competitive salary": You'll make more than you would at the local McD's. But not much.

"Generous benefits": Secretary has a bowl of M&M's on her desk.

"Cultural offerings": Office fridge hasn't been cleaned in years.

"Topnotch school system": Most kids finished 8th grade.

And my favorite:

"Year round activities": What does that mean? Hell, cleaning my house is a year round activity.

Sunday morning, 6:47 a.m.

My cell phone rings. It's the hospital ID.

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

Ms. Huc: "Hi, I'm calling from 7-East. Did you get a consult on Mr. Whacky on Friday?"

Dr. Grumpy: "Yes, but when I spoke to the internist he told me it had been written by mistake, and that they didn't need a neurologist. So I didn't see him."

Ms. Huc: "Ohhhhh... I was just looking through the chart, and trying to figure out why you didn't see him."

Dr. Grumpy: "Do they need him seen now? I can come in later today."

Ms. Huc: "Hang on, let me ask his nurse." (pause) "No, never mind. He went home last night."

Memories...

In residency, young doclings have clinics, learning how to do outpatient medicine in the hopes that we'll be able to do it when we grow up.

Grizz, another resident in my year, had a clinic epilepsy patient who had HUGE surgically enhanced breasts. She also used craploads of make-up.

Anyway, another resident was getting married, and so we planned a bachelor party for him over at Local House of Boobies. It was a fairly successful event (from what I remember) involving alcohol, topless dancers, a large number of $1 bills, and I think some silly string.

Anyway, at one point I paid a stripper to come over and give Dr. Bachelor a lap dance. So she got started doing her thing, then abruptly stopped. She looked at Grizz and said, "Hey! You're Dr. Grizz! I see you over at the epilepsy clinic!"

Grizz looked like he wanted to die. He turned a shade of red I hadn't seen before or since.

She walked over and rubbed her breasts on his head "You're awesome! I love that new drug you have me on, because it doesn't affect my balance when I'm dancing!"

Then she resumed the show.

Grizz didn't go to anymore bachelor parties after that.

Sitcom in my office

Mr. Patient: "Dr. Internist told me to see you about my arm pain. He also wanted me to mention that I'm having memory loss."

Dr. Grumpy: "Okay, let's start with the arm. How long has it been hurting you?"

Mr. Patient: "I don't remember."

Things that make me grumpy

I had a hospital consult yesterday afternoon. So I swung by the doctor's lounge to grab a Diet Coke, and then went to find my patient.

While I was waiting for the elevator, I popped the can open. Unfortunately, it exploded, showering me and the floor with soda.

Shit happens. Oh well. I ran to the bathroom next to the elevator, grabbed a handful of paper towels, and came back to clean up the mess.

As I'm working on it, Dr. Helmsley wanders by, and asks me what happened. I told him my Diet Coke exploded, and so I'm cleaning it up.

He laughed and said "I wouldn't bother. You're a doctor. The hospital pays drudges to do that." Then he walked away.

Screw you, Dr. Helmsley, and anyone else who thinks like that. Just because we have advanced degrees and training, DOESN'T EVER exclude us from normal courtesy. My mother always told me that if I make a mess I should clean it up. Not leave it for someone else to deal with.

And if you think being a doctor , or driving a Porsche, or ANYTHING exempts you from that, then your mother needs to slap the shit out of you.