Another one bites the dust

I don't do that much teaching anymore. I like it, but the constraints of time with a family and solo practice make it damn near impossible.

But I still do it, albeit rarely, on special requests from friends, nurses or docs I know, etc. And yesterday was one of those days.

I got my start in a college program where I shadowed docs to see if I wanted to be one, and so I have a tender spot for those kids. Last week one of the hospital nurses called me. Her son is in his 2nd year of college, and is thinking about medicine. She was calling around to see if anyone would let him watch for a day. And since I'm a softy, I said sure.

He shows up, neatly dressed, trying to look young, eager, and professional. My first patient was in for an EMG (electrical test of the nerves and muscles), and she didn't have a problem with the student watching.

I fired up the machine, and made some notes. Joe College leaned over my shoulder to see what I was doing. I stuck a needle in the patient's deltoid, and turned to the machine to look at the results.

There was a loud "thunk" behind me. The patient and I both turned to see Joe College sprawled unconscious on my exam room floor.

The patient began laughing. I pulled the needle out of her arm and called Mary for help. We got Joe out to the break room as he woke up, and got him some water.

By the time I was done with the EMG he was gone. He'd told Mary he was thinking about becoming a pharmacist or accountant. He also asked for her phone number.

History FAIL!

"I had my kids way back, in the 1970's. They were complicated births, because they hadn't invented the C-section yet."

Only outside Sleepy Hollow

Mr. Patient: "My chiropractor says this is because the top of my neck attaches to my head. Is that a common problem?"

Attention Drug Rep!

Thank you for bringing lunch today.

I am married. You may not have noticed my ring. Or my kid's drawings all over the place. Or the brief phone call I had with Mrs. Grumpy in front of you to work out who's picking up the tribe tonight.

Batting your eyelashes, adjusting yourself in your chair so that all of us could see you're wearing a thong, talking about how lonely you are being new in this town, and giving me a card with your home phone on it "just in case you have questions about the drug, or anything else" does NOT score you points in my office.

Try the plastic surgeon downstairs. His trophy wife (3rd wife, 28 years younger then he is) just turned 35, so he's likely looking for a newer model.

Thank you.

Is that your final answer?

I'd like to thank my reader Kate for submitting this. She found it on Answers.com.

Beyond the question of "Why the hell is this listed under 'math'?", is the remarkable answer itself.

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Early monday hospital rounds

Dr. Grumpy: "Why did you call 911?"

Mr. Phlush: "Because my toilet was clogged."

Dr. Grumpy: "Why on Earth did you do that?!!!"

Mr. Phlush: "I don't know any plumbers."

Today's Health Tip

Just reminding all my readers to eat plenty of ice cream, because it supports a healthy lifestyle. After all, it says so on the carton.

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And thank you to my reader Trout for submitting this!

Memories...

One of the most hated parts of residency is having to call an attending at night about a new admission. In most programs this is required, and you don't have a choice. It consists of dialing up the senior doc on call, running a case by them quickly, and making sure they agree with what you're doing.

Generally you try and make it quick. You're busy. They're trying to sleep.

There was one doctor in my program, Dr. Flat, who was notorious for his rapid monotone. He spoke at warp speed, but his voice never changed, and he never strayed from business. If he had a sense of humor, none of us ever saw it.

One weeknight I was on call, and was admitting a stroke patient. It was about 10:00 p.m, and I made the obligatory call to Dr. Flat.

Dr. Grumpy: "So I'm admitting him to the telemetry floor, and started him on Aspirin. I've ordered an MRI, and..."

Dr. Flat: Mmmmm. YAWNNNNNN

Dr. Grumpy: "I'm sorry, sir. Did I wake you up?"

Dr. Flat:"No, my wife and I just finished having sex. What's his blood pressure?"

Patient quote of the day

"I forget the things I can't remember. When I was younger I used to remember that stuff. I mean, I'd remember the stuff I hadn't forgotten."

Fashion and medicine

Dr. Grumpy: "Okay, we're done with the EMG. I'm going across the hall to my office. Why don't you toss the paper gown in the trash, put your shirt back on, and meet me over there to discuss the results."

Mrs. Hedinbutt: "It's not a shirt. It's a blouse."

Dr. Grumpy: "Okay. Anyway, after you have it on, come over and..."

Mrs. Hedinbutt: "Don't you even know the difference?"

Dr. Grumpy: "Well a..."

Mrs. Hedinbutt: "For crying out loud! You're a doctor and you can't even tell a blouse from a shirt! How did you get through medical school!"

(long pause)

Dr. Grumpy: "Look. Do you want to go over the EMG results or not?"

Mrs. Hedinbutt: "I don't have time for this. Just send them to Dr. Imed and I'll discuss it with him." (puts on blouse/shirt/vest/tunic/upper body garment/whatever and leaves).

Attention patients!

Your appointment is over. You are certainly welcome to wait in my lobby for your ride, to complete paperwork, or to have some water to recover from your grueling appointment with me.

However, please DO NOT USE my lobby for any of the following activities:

To use a phone (mine or yours) to make political calls on behalf of whatever candidate you're supporting this year. I respect your right to be involved in politics, but my waiting room isn't the place to do it. Not everyone out there agrees with you.

To have the sandwich, pickle, and bag of chips you've been carrying around in your purse. I don't mind you grabbing lunch in a hurry, but spending an hour here eating, calling friends, and using my magazines as napkins is a bit much (If this sounds familiar to you, asking Mary if we had any salt and a can of Sprite was over the line).

To call several local restaurants to set up catering for a party.

To try and sell real estate opportunities to other patients who are waiting to see me.

To see how much more (or less) your specialist co-pay is compared to other patients.

To hand out flyers to see your band play at Bubba's Roadhouse this weekend.

To argue about ANYTHING featured in "People" magazine.

To wait and see if a drug rep with samples of your medicine wanders in, and then assault them.

To ask my other patients what they think of your stock-market investment picks.

To appoint yourself schedule monitor, and tell Mary who signed in before whom.

To get out a scissor and cut coupons, articles, pictures, and anything else that strikes your fancy out of my lobby magazines.

Thank you.

Comparing apples to apples

Like most docs, I use Epocrates on a PDA for medication info. It's not perfect, but very helpful.

So today I had to look up something on Topamax and found this, under "Look/Sound alike drug names"

"Topamax may be confused with Topiramate"

They're the SAME FREAKING DRUG, for crap's sake!!!

(For those of you looking this up on your PDA, it's under "Safety/Monitoring")

Tuesday night, 7:15 p.m.

"Hi, Dr. Grumpy. My husband sees you for Parkinson's disease. Anyway, I'm in Calorie Counters, and we have a meeting tonight in the church down the road from your office, and our scale is broken, and I know you and Dr. Pissy have one in your hallway there, and I was wondering if you could meet us at your office and let us in to use your scale for a few minutes."

Mary's Desk, August 24, 2010

Mary: "Dr. Grumpy's office, can I help you?"

Mrs. Hiazakite: "HI! I need to get in to see Dr. Grumpy! I've heard he's wonderful!"

Mary: "Okay, we have a new patient appointment this Thursday at 2:00. Will that work?"

Mrs. Hiazakite:"I really wanted to get in today. Please? Pretty please? I'll bring you cookies!"

Mary: "That's nice of you, but I'm sorry. Thursday is our next availability."

Mrs. Hiazakite:"Will he give me some Percocet at least, like this afternoon? Just to tide me over?"

Mary: "We don't prescribe to patients that aren't established."

Mrs. Hiazakite:"That's totally unfair! Please! I said I'll bring you cookies!"

Mary: "I'm sorry, but you need to find a different doctor. I'm getting off the phone now."

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