Monday, March 28, 2011

Devotion to duty

This weekend I got dragged kicking and screaming called in to see a hospital consult. It was a lady who'd had her appendix out, and had a bad headache afterward.

Dr. Grumpy: "Have you had headache problems in the past?"

Miss Shiny: "No... Hey! Are you Dr. Grumpy, from downtown Grumpyville?"

Dr. Grumpy: "Yes, that's me. Have you seen me before?"

Miss Shiny: "No, but I work for Big Pharma, Inc. One of my partners is a drug rep who calls on your office. My territory is over on the east side."

Dr. Grumpy: "Oh, okay. Anyway do you normally get headaches?"

Miss Shiny: "Have you considered prescribing our product, Noshakesatall, for your Parkinson's disease patients?" (reaches in purse, pulls out a sales brochure) "If you look at this graph, Noshakesatall shows superior efficacy and duration of action in treating Parkinson's, and..."

Saturday, March 26, 2011

Happy whatever

I'd like to thank my reader Kelly for sending this in. She writes:

"Petersen therapy is across the street from our office. They send us faxes with seasonal trivia and asking us to refer patients. This one came on Thursday. The fax date stamp (March 24, 2011) is at the top."

click to enlarge



Thank you, Kelly!

Note- for my non-North American readers, Thanksgiving is celebrated in the Fall.

Friday, March 25, 2011

Attention patients!

If you have a wart on your leg (or anywhere) PLEASE refrain from picking it off while talking to your neurologist.

The fact that you take Coumadin doesn't help.

Normally I don't charge for the Kleenex on my desk. But at the rate you're going through them I might have to start.

On the other hand, it's cheaper than a carpet cleaning service.

The Horror!

Local Hospital has elevator doors with lights that flash green when they're opening and red when closing.

I'm done with afternoon rounds. I get in the elevator to leave.

The elevator stops on the 6th floor and a lady and her little kid get on.

Little Kid: "Mommy, why do the elevator doors have those green and red lights?"

Mom: "So blind people know which way the doors are moving, honey."

Just shoot me. She was pregnant, too.

Thursday, March 24, 2011

Current 20 something

Has her name:

1. On her necklace

2. On her right hand ring

3. Tattooed on her left forearm.

4. Tattooed on her right ankle

5. And on a left toe ring

I have to wonder if this is so she doesn't forget it.

Jupiter is lovely this time of year

Dr. Grumpy: "Are you allergic to anything?"

Mrs. Flake: "Oxygen. I can't be anywhere near the stuff. I can't breathe it at all. Just being around it makes me horribly sick. I can only go places where there isn't any, so I don't accidentally inhale it."

Wednesday, March 23, 2011

Things that make me grumpy

All right, this just pisses me off. Here's a doctor who's been suspended for re-using prostate biopsy supplies on patients. NOT re-sterilized. Just using the damn things until they get "too bloody" to keep using. And we all know how clean that area is.

Wanna get angry, too? Here's the link. (Thank you, Andrew, for sending this in).

Stories like this aren't new. Since we invented money some people have always tried to find ways to rip others off.

But in health care it somehow seems worse. Nurses have done it, too. And pharmacists.

Why the hell would anyone do this? Especially after all the damn training we go through?

I'd like to think they're just stupid. It doesn't make it better, but it's somehow easier to accept than the more likely option: greed.

If the doctor keeps re-using the biopsy equipment, it's good for his overhead. He has to buy fewer supplies to do the same number of billable procedures. He may even be charging the insurance for a new kit each time he uses the old one.

The pharmacist knew what he was doing. Just greedy.

The nurse is a little less clear. Maybe she's just lazy. But who knows? Maybe she took the fall for a greedy hospital that secretly condoned such a practice. Maybe they were paying under-the-table bonuses to staff who found illicit ways to save money.

Regardless, ANY doctor, nurse, pharmacist, or other health care person, who does ANYTHING for personal gain at the expense of a patient, should never be allowed to do this job again. These people come to us for care, and screwing them over for your profit line is absolutely unforgivable.

To me, this is worse than fraudulant billing (example: charging for taking off a mole when you really didn't). They're both wrong, but when you intentionally put it a patient in harm's way just to make a buck, you should be banned from medicine forever (provided you haven't already been locked up).

In medicine the prime directive is "do no harm". This is a balanced statement, because obviously we DO harm: Surgeons cut people open. Chemotherapy can make you horribly ill. I do procedures with needles. The issue is that in these cases we're doing harm with the overall end result being (hopefully) for the better.

But when you cross to the dark side, and knowingly hurt a person to make some extra dollars, you should be hung out to dry.

And if you're in this field, and disagree with that, then get out of it now.

Medical students: I'm a PGY-18. And some fires never go out. And I hope they never do.

Tuesday, March 22, 2011

The Time-Traveler's Neurologist

This message was left on Mary's voice mail at 10:35 this morning:

"Hi! This is Mrs. Clock. I need someone to call me back at home. I'll be at the house until 10:15 this morning, and it's 10:30 now, so if you can call me back before I leave 15 minutes ago that would be great."

Ibee Idiot, M.D.

I'd finished an appointment yesterday afternoon, and was walking the patient up front.


Mrs. Crotchety: "You seem like a nice doctor, and smart too. I've seen 2 different neurologists before, both times when I was in Local Hospital. They were both incompetent idiots."

Dr. Grumpy: "Thank you. I'll get those records to review, and Mary will help set up this test."


I walked back to my office, and logged into the hospital computer system. The patient had seen neurologists there in 2005 and 2007.

And both times it was me.

Monday, March 21, 2011

Adventures with the Boy Scouts

Craig spent Saturday at a Scouts' activity, trying to earn his Craftsman badge. They were doing woodworking, clay, and other assorted stuff.

One of the projects was to make a roughly 4" tall ring-holder out of clay.

Without further comment, I'm now posting front & side views of the ring-holder my son made with the Boy Scouts.




Sunday, March 20, 2011

Breaking news! Stop the presses!

When Dr. Grumpy was a teenager he had...

(head down, whispers)

zits.

Yes, that horrible scourge of adolescence. I had zits.

The pimples, as always, popped up at the worst time. Like the big honker on my nose just before a date. Or asking Suzy Weintraub out. Or other (by teenage standards) major-league events.

And yes, it was depressing. It made me feel ugly. And so (like many other teenagers) I invested my hard earned money in whatever product promised results. Because what girl would want to go out with a guy with a zit the size of Sheboygan on his forehead?

And, although you were ashamed to talk to other kids about zits, EVERY teenager obviously felt the same way. Hence, the enormous success of Zitzaway! and other skin care products aimed at adolescents. Hell, zits even had their own page in the unofficial puberty bible "What's Happening to Me?"

So, obviously, zits are a longstanding, well-known, part of adolescence, impacting emotions and confidence. Right?

Of course, actually having gone through puberty, or having kids doing so, just isn't good enough. Someone actually had to STUDY THIS!

And they found that (SURPRISE!) having zits in adolescence can effect the way you feel about yourself!

Really. Here's the article.

Saturday, March 19, 2011

Weekend reruns

Due to the usual crazy amount of kid stuff, I'm re-running this from about 2 years ago.


Being a neurologist means sometimes being LOUD. In residency, no matter how quiet and soft-spoken you may be, you learn how to SHOUT, yet still be polite.

Is this because we deal with little old deaf people? A little. But the main reason is because we are frequently consulted to wake the dead (or at least try) and evaluate the comatose. In order to do so you need to make sure that this person definitely isn't responding. So you learn to be able to shout into their ears in the gigadecibel range, to see if they can actually hear you.

And you yell simple commands, trying to break through a wall of brain damage, drugs, and loud ICU machines to see if there's anyone in there. "MR. JONES! CAN YOU WIGGLE YOUR TOES FOR ME?" or "MRS. SMITH! CAN YOU SHOW ME TWO FINGERS?"

If you don't believe me, just ask any ICU nurse. They often carry their own earplugs for when they see a neurologist going into a patient's room.

This morning I got called in to evaluate a guy with brain damage named Mr. Dick.

So I did my usual shouting routine to try to wake him.

"MR. DICK! CAN YOU HEAR ME? CAN YOU HOLD UP TWO FINGERS?"

No response.

"MR. TOES! CAN YOU WIGGLE YOUR DICK FOR ME?"

Mercifully, the patient didn't respond. The nurses' station, however, broke down in hysterical laughing. So did the patient 2 doors down. I'm sure I turned bright red when I realized what I'd said.

Leave me alone. It's 5:00 a.m., and I haven't had a Diet Coke yet.

Friday, March 18, 2011

Kids

Mary told me a drug rep I like was up front, so I went to sign for samples and say hi.

Mrs. Rep: "Sign here... How have you been?"

Dr. Grumpy: "Fine. I thought your kids were on Spring Break this week?"

Mrs. Rep: "They are."

Dr. Grumpy: "Oh, I thought you'd said you were taking this week off to spend time with them."

Mrs. Rep: "I did, but they drove me nuts. This morning I couldn't take it anymore. I called in sick for my husband, and told him I was going to work. He can deal with them."

Thursday

Mr. Vegas: "My wife is a nurse, and wanted me to see you. She says she knows you."

Dr. Grumpy: "Oh, where does she work?"

Mr. Vegas: "I have no idea. We just met last weekend."
 
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