Tuesday, June 14, 2011

Signs of the Apocalypse




Because, ya know, the world REALLY needed a pizza that's perfect for when it's late at night and you and your buddies are wasted from drinking too much microbrew and you need something to line your stomachs while you watch subtitled art-house flicks on DVD.

Hospital rounds

I'm sitting at the nurses station, scribbling in a chart. Two nurses walk by, talking.

Nurse 1: "So I woke up this morning, and I'm still bleeding. I need to call my GYN back, because... Oh! Here's Dr. Grumpy! Hey, doc, I have a problem, let me ask you..."

Dr. Grumpy: "Hey! I'm a neurologist! I don't deal with that end!"

Nurse 1: "I just wanted to know if we could give Mr. Carotid sedation for his MRI. He's claustrophobic."

Monday, June 13, 2011

Accuracy in biological nomenclature

When assaulting someone with a dead animal that you randomly found lying in the road, it's always important to know exactly what species you are armed with.

Thank you, JoAnna!

Human nature

Mrs. Marlboro: "What can I do to prevent having another stroke?"

Dr. Grumpy: "Quit smoking. You also need to start taking your medications as prescribed."

Mrs. Marlboro: "That's a lot of work. Can't I just take a vitamin or something?"

Sunday, June 12, 2011

Sunday reruns

Thank you for coming in on this lovely Friday afternoon, ma'am. I guess you called around 1:30 today, and since we didn't have a 4:00, which is my last slot of the day, Mary put you in. Let me just open another Diet Coke, and we'll get started.

So you've had headaches for the past 20 years? And never seen a doctor before for them? What made you come in today, of all days, for this? Oh, you did a Google search.

Thank you for this printout of all the horrible types of brain tumors and aneurysms that can cause headaches and kill people. I appreciate it, because as a board certified neurologist with over 10 years of experience I really have no idea what sorts of things can cause headaches.

If you'd read it you might have noticed that the average survival from these awful things is 1-2 years, not 20. But I'm sure you're busy and didn't have time to actually read the articles you were printing up. After all, you had your hands full calling every neurologist on your insurance plan trying to find one who still had openings on this lovely Friday afternoon.

Of course we can get an MRI. I understand it would make you feel better, and allows me to cover my own legal butt, too.

Oh, you're claustrophobic? No, an MRI is really the best test we have right now for evaluating this sort of thing. I'm sorry that Reader's Digest somehow gave you the impression that I had a gadget in my office I could wave over you to make sure everything is okay, but I don't. Dr. McCoy borrowed my tricorder a while back and hasn't returned it yet. But we can do the MRI with Valium to relax you, if such a thing is possible.

I'll have my staff schedule the test for next week. No, I'm sorry. It's now 4:00 on a lovely Friday afternoon. Your insurance company requires an MRI request to be approved by a panel of dart-throwing chimpanzees before agreeing to pay for one. All of their offices are in another time zone, and have closed by now on this lovely Friday afternoon.

You really feel you need it immediately? Then the only thing I could suggest would be to go to an ER, and tell them you need an MRI right now. I'm sure, that after hearing your story and realizing how urgent this is, as opposed to a guy with chest pain, the ER doc will be happy to waste spend time and money on your case. Just don't tell him that I'm your doctor.

Oh, I had no idea your ER co-pay was so high. $50 does seem a bit extravagant for a lady with diamond rings on every finger and Porsche keys hanging out of your LV purse. I certainly can understand your refusal to go there.

Then it will have to be next week. My staff will call your insurance first thing Monday morning to get this authorized and scheduled.

Your insurance coverage runs out at the end of this month? My calender shows that today, May 29, is a Friday (which is a lovely afternoon by the way) and the last workday of the month. So Monday will be June, and we won't be able to get the MRI from your current insurance then, since it will have run out.

What insurance will you have on Monday? I'm sorry, I'm not contracted with that plan. I can send your internist a letter asking him to order the MRI. Oh, he's not contracted with it either. I see.

Yes ma'am, I agree it was entirely unreasonable of Mary to not have foreseen that you'd be changing to an insurance I don't take next week. You didn't mention that to her when you called for this appointment a few hours ago, but she really should have known, anyway. I'll discuss her suboptimal psychic powers with her at her next job evaluation in 2018.

I'm sorry you have to go already. Well, try to take it easy over the weekend, and I'll send my records to a neurologist on your next insurance, so they can help you out.

Going to a hockey game tonight sounds like fun, and it's great that you have such good seats. That looks like a nice air horn in your purse. I'm sure that sort of quiet, relaxed environment will help improve your headaches in the meantime. Thank you for sharing this lovely Friday afternoon with me.

Saturday, June 11, 2011

WTF?

My wife bought this recently. It makes no sense to me.

It's like saying "Denver-style Texas BBQ." Or "Seattle-style New York Cheesecake."


Friday, June 10, 2011

Miscommunication

Dr. Grumpy: "When did the migraine start?"

Mrs. Armoire: "Monday, when my husband and I were talking. He'd just come out of the closet."

Dr. Grumpy: "That must have been quite a shock."

Mrs. Armoire: (gives me weird look) "Not really. He was putting away his jacket."

Thursday, June 9, 2011

Technical support

Thank you to the reader who sent me this picture.

Because, ya, know, maybe there is someone out there who's never seen one of these, and needs a tip about what it's for.

But then WTF are they doing buying home electronics?


Trouble brewing

I got dragged in to ER last night to see an acute stroke. In the next room there was a 16 year old guy wailing and screaming uncontrollably.

He'd taken the family car without permission. Wrecked it. Knocked over a traffic light, broken both legs. And (of course) didn't have a license.

He was fine and quiet with all this until he found out his mom was coming to the hospital. And then he REALLY freaked out. Not over the wreck... but because she'd see that he'd gotten a tattoo on his chest.

"Oh my God! She's going to kill me! She hates tattoos! Please! Somebody, give me a gown, a shirt, a towel, anything, please, I gotta cover this! Please! Why did you guys have to cut my shirt off? This is going to get me in such deep shit. Somebody! A blanket! Or even a big band-aid! Or something, anything, to put over it."

Wednesday, June 8, 2011

Details. I need details.

Dr. Grumpy: "Are the new headaches like your migraines?"

Mr. Hedpayne: "No. They're different."

Dr. Grumpy: "In what way?"

Mr. Hedpayne: "They aren't the same."

Another satisfied customer

My 2:00 new patient yesterday didn't show up. It happens. I forgot about it and moved on.

Last night I got the following message on my voicemail:

"Dr. Grumpy, I'm never coming to see you again, and am going to complain about you to my internist. I had a 2:00 appointment with you today, and I waited in your lobby for 2 hours, and nobody called me back. I kept pointing this out to the girl at the front desk, and what did she do? NOTHING! She kept telling me that I didn't have an appointment there, and that I had the wrong office, and that you were in a different building! If this is how you treat new patients, then I don't see how you're still in practice."

Tuesday, June 7, 2011

And it looks like you failed, too

I'd like to thank the reader who sent in this picture. She says the cake was at a "School's Out/Birthday" party she took her kids to today.

(click to enlarge)


Dr. Grumpy, uncaffeinated jackass

It's early morning. I need some caffeine. I'm in the little kitchen on Local Hospital's neurology floor. And I'm pissed off.

Dr. Grumpy (yelling at no one in particular): "This is bullshit!" (slams cabinet) "Who the hell puts stuff away here?!!!" (slams drawer).

Nurse Understandablyannoyed comes into the kitchen: "What's wrong?"

Dr. Grumpy: "All I want is some freakin' sweetener for my coffee! And I've been through every damn cabinet and every damn drawer in here! And there's none! I thought they were keeping these stocked!"

Nurse Understandablyannoyed: "They do. It's..."

Dr. Grumpy: "Then where is it?!!! I've looked everywhere in here!"

Nurse Understandablyannoyed: "... it's in the box on the counter, about a foot in front of you, out in the open."

(Long pause)

Dr. Grumpy (red-faced): "Yes. I knew that. I was, uh, just testing you."

Monday, June 6, 2011

Clarity

I'm reviewing some records today, and found this quote:

"This EEG is normal. But it may also be abnormal."
 
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