Monday, December 22, 2014

Heading west

All right, we're heading to visit family on the west coast, and hopefully warmer weather, for the holidays. I'll be back in 2 weeks.

Whatever you celebrate, have a good one. If you don't celebrate anything, at least call your mother once in a while. She says it wouldn't kill you to pick up a phone. She's worried you aren't eating properly, and needs to tell you something about your cousin Max, Naomi's boy. You met him once at a birthday party in 1972, remember? He was the one with braces.

Sunday, December 21, 2014

Weekend reruns

Dear Mrs. Nosybich,

Sorry about our little dispute at the school last week. Normally I don't take the kids in the morning, but Mrs. Grumpy had an early meeting that day.

It must be nice having a child that is naturally compliant with your orders. Frank, however, is not like your daughter, and will fight us to the death about wearing a jacket. Getting him to wear a sweatshirt over his clothes took an act of Congress and delicate negotiations. While it's not perfect, it was a halfway compromise.

So far he hasn't frozen to death or caught pneumonia/swine flu/AIDS/cooties/halitosis, or any of the other disorders that you seem to think are floating through the air specifically targeting unjacketed children.

But I'm glad you were concerned enough about someone else's kid to take time out of your busy day, walk over to me, and make a scene in front of all the other parents about how you've been watching the "horrible neglect" practiced by my wife and I. I appreciate you running down a list of communicable airborne illnesses that you got from Google, and closing your argument by threatening to report us to Child Protective Services if you ever see my kid without a jacket again.

I think it's great that you want to pay such close attention to the failings of us lesser parents. Reminded me of the Charlie Brown cartoon where Lucy took it upon herself to write New Year's resolution lists for everyone else.

I really like the way you punctuated your tirade by slamming your daughter's car door, HARD, to make sure we were all paying attention. We definitely all were (except your daughter, who looked too terrified to speak) because me, 3 teachers, and 20 other parents immediately began trying to tell you that you'd just slammed one of her backpack straps in the door. But you were clearly more concerned with my crappy parenting skills to notice.

Fortunately, your child had the presence of mind to let go of the other strap after she'd been pulled down and dragged about 3 feet as your drove away. And I have to admire the teacher who boldly leaped in front of your car to make you slammed on the brakes, at the risk of her own health.

Your kid will be okay, I swear. She has a small cut on one hand, and a tear in her jacket where it got dragged (maybe you should get her a new one).

I felt so awful about it too. You made me feel very guilty when, after you checked your kid and released the backpack strap from the car door, you turned to me and yelled, "Now look what you made me do!" before getting in your car and driving away.

Happy holidays.

Friday, December 19, 2014

Quote du jour

"I'm allergic to arsenic."

Thursday, December 18, 2014

Dr. Grumpy's gift guide

Do you miss your old Polaroid camera? The thrill of waiting for the wet picture to come out, watching it develop as you flapped it up and down only to find out it was a horribly overexposed shot of your foot?

Me, neither.

I also don't want anyone taking my picture in the bathroom.

BUT if for some reason you're nostalgic for the first, and find the second appealing, here's a perfect idea: The Polaroll!

This cleverly designed toilet paper dispenser provides the best of both worlds. The paper rolls out where the snapshots used to, and you can imagine your life is actually interesting enough for someone to want to spy on you in the bathroom.

Unlike the original Polaroid films, I DO NOT recommend shaking the TP around after use.

Wednesday, December 17, 2014

Trivial Pursuit

I love Wikipedia. Every year I donate to Wikipedia (I recommend you do, too).

Why? Because I love learning stuff. Granted, Wikipedia is far from perfect, but nothing is. And for someone who likes trivia, it's awesome. In quiet moments I can click the "random article" feature repeatedly and learn all kinds of new stuff.


There are some things I'm sorry I've learned. Things I likely could go to my grave perfectly happy without knowing about.

For example:

The Hulaburger. In 1963 McDonalds (briefly) test marketed this bizarre creation, hoping it would sell with Catholics on Fridays. It consisted of a bun, cheese, ketchup, pickles, onions- and a thick slice of pineapple. It was invented by Chairman Ray Kroc, and I can only assume it got as far as it did because no one dared tell him it was insane.

The Ethel Merman Disco Album. In 1979 the legendary Ethel Merman felt the need to record some of her biggest Broadway hits as disco numbers.

The Bud Bowl scores. Of course I remember the odd "Bud Bowl" advertising campaign of the 1990's, featuring football playing beer bottles. It only aired during the SuperBowl, and some years was more exciting than the game itself. And I'm not surprised the ad campaign has a wiki page. But what frightens me is that someone actually tracked the final scores of each of Bud Bowl and put them in the article.

The ingredients in a McRib sandwich. I personally have never eaten a McRib, nor do I plan to. And if I ever had the slightest thought of such, learning that the faux-rib-shaped patty is made of pork shoulder and "restructured meat products such as tripe, heart,and stomach" would drive it out of my brain FAST.

As a child of the Atari 2600 age, I figured I'd played all of the titles for it. Even the shitty Atari Pac-Man, which I saved money for, raced home with, and was absolutely horrified to discover bore absolutely no fucking resemblance whatsoever to the arcade game. But I digress. Anyway, I was shocked to find out that there was actually an Atari game based on the rock group Journey.

I suppose nothing should surprise me where pornography is concerned, but learning that there's a porn flick based on the "Mario Brothers" video game franchise still did.

I am not a "high 5" person. I have never been, and will never be, a high-5 person. I have one patient who feels the need to give me high-5s multiple times at each appointment, and it drives me nuts. So I was especially horrified to learn that there is actually a national high-5 day.

These, and many less-strange facts (and a few more so) can all be found at Wikipedia. Expand your mind!

Tuesday, December 16, 2014

Commas. There's a reason.

Seen in a chart:

Thank you, A!

Monday, December 15, 2014

Dr. Grumpy's gift guide

Still looking for the perfect plunger for your bathroom? Want one that exudes refined taste? (good luck, there isn't one) Worried about people threatening you in the john and not having a weapon handy?

Then look no further!

This lovely toilet plunger is cleverly designed to resemble a shotgun. When in use, or simply by pulling the trigger, it plays a loud shotgun blast.

To further improve its aura of elegance, the gun barrel is clearly labeled "IF IT'S BROWN, IT'S DOWN!"

Friday, December 12, 2014

Dr. Grumpy's gift guide

A lot of us grew up watching "Rudolf the Red-Nosed Reindeer" every December.

One popular number from the show is "The Island of Misfit Toys," about a place where defective and unwanted toys are sent. I kind of liked that song. It was somehow reassuring, as a kid, to think that even junk the charities wouldn't take still had a place to go (when you get older you find out it's called a landfill).

Until this week.

Thanks to my reader Don I learned of a toy so terrifying that I'm sure it's not welcome on the island. Hell, it may not be wanted in the landfill, either.

"Even misfit toys have their standards, Rudolph."

Apparently this gadget was purchased at a toy store that sold stuff no decent emporium would carry. And it was half-off there. If you're marked down at a place that isn't known for its quality... that's a bad sign already.

So what am I getting at here? This:

"Wait, it looks kind of cute."

Yes, it's G.G. Giraffe (the initials are for yelling "GOOD GOD!" when you turn it on) from the "Forest Friends" collection. I should note here that giraffes don't even live in forests. They live in savannahs.

The box goes on to say that G.G. "Walks along, moves head, and shriek" (sic). The first 2 don't sound so bad. I mean, a lot of toys do that. And he does look sort of cute.

But it's the 3rd, regardless of erroneous verb tense, that sets G.G. apart.

Generally, shrieking isn't something that's really desired in a children's toy. Unfortunately, in a rare example of honest marketing, it's also the only thing G.G. does horribly well. Let's listen to what happens when he's switched on:

Paging Doc McStuffins, STAT!

So, while I don't recommend G.G. for your own kids, I think he's an excellent choice for the offspring of in-laws you're less than fond of. Preferably those who live out of state. WAY out of state.

Thank you, Don!

Thursday, December 11, 2014

Hi, honey, I'm home.

Seen in a hospital chart:

Wednesday, December 10, 2014

Just add reindeer!

One of my readers is an OB/GYN who recently had foot surgery, and therefore is (allegedly) non-weight bearing. Like most docs (we're generally terrible patients) she's not going to let that slow her down.

So she's hobbling around the hospital this month using a knee scooter.

Of course this is the Christmas season. So while she was doing a C-Section (without the cart, it's not sterile) her ride was left at a nurses station.

When she returned, she found the staff had aggressively pimped it out:

"The 'eggnog' flask is hidden under the cushion."

I think that's just awesome. All it needs now is some flashing lights.

Thank you, K!

Tuesday, December 9, 2014

Dr. Grumpy's gift guide

Does your man like looking at gorgeous women? Probably.

Does he also have a SERIOUS carp fetish?

Okay, maybe the 2nd one is a bit... uncommon. But if he's into both, do I have the gift for you!

The German camping supply company Carponizer proudly introduces their 2015 KarpfenKalender!

"I'm wearing less than this inside. A lot less."

No need to get your guy 2 separate calenders (one with women and another with carp) that he'll be forced to alternate looking at. Now he can have the erotic pleasures of Europe's most beautiful woman AND enormous carp IN ONE GREAT COLLECTION! Every month will bring him pictures of sizzlin' babes and smokin' fish in high-resolution color.

Stunning models and scaly osteichthyes... What more could you want?

Not to be outdone, Carponizer's English rival, Top Fishing Gear, has introduced their own "hot chicks and cold fish" themed calender for 2015, featuring, well, similar stuff:

Either calender would be an ideal gift for a man who enjoys using his rod & reel. Order yours today!

Monday, December 8, 2014

Picture quiz

This is from:

A. The 2015 Lady Gaga footwear line

B. Guide to S&M fetishist shoe styles

C. The Human Torch and Friends Visit the Doctor.

D. "But these were not an ordinary pair of black and white pumps; both were left feet, one had a right angle turn with separate compartments that pointed the toes in impossible directions. The other shoe was six inches long and was curved inward like a rocking chair with a vise and razor blades to hold the foot in place."

E. An ad for pain medicine.

Sunday, December 7, 2014

December 7, 1941

December 7, 1941, was a landmark day in American history, but this post isn't about the story you've heard. The events at Pearl Harbor are well known, but what's virtually forgotten is what happened 142 miles away that same day.

Ni'ihau is the forgotten Hawaiian island. It's an idyllic place, covering 70 square miles, at the western end of the group. Except for a few military staff or privately arranged visitors, it's off-limits to outsiders. The year round population is roughly 150 people, and the primary language used is Hawaiian. Except for it briefly being considered as the location for the United Nations headquarters (really!) in 1944, it's rarely in the news. Today it exists in a fairly unspoiled condition as an environmental sanctuary. It's been privately owned by the Robinson family since 1864.

In 1941 Ni'ihau had no connection to the rest of the world, except for a weekly supply boat that came from Kaua'i on Mondays. There was no radio on the island. The Robinson family had a home there, but the majority of the 136 inhabitants were native Hawaiians who farmed and raised livestock. If there was an emergency, they would build a signal fire and the Kaua'i police would send a boat.

Many details of the events I'm going to tell you about are sketchy, and there are several different variations online. But the overall theme is the same.

December 7, 1941...

Airman 1st Class Shigenori Nishikaichi, IJN

Pilot Shigenori Nishikaichi had left the aircraft carrier Hiryu that morning, part of the second wave to attack Pearl Harbor. During the battle his Zero fighter was damaged by antiaircraft fire, severing lines and putting holes in his fuel tank.

With gas running out and difficulty controlling his plane, he headed in the wrong direction and found himself over tranquil Ni'ihau. Picking out the best landing spot he could find, Nishikaichi bounced across a pasture, through a fence, and into a pile of rocks before coming to a stop near the town of Puuwai.

The unusual event was witnessed by Hawila Kaleohano, who lived nearby. Although unaware of the attack on Pearl Harbor, Kaleohano knew from the weekly newspaper delivery that diplomatic relations between the U.S. and Japan were deteriorating. Recognizing the plane as Japanese, he opened the canopy and took Nishikaichi's revolver and papers before the pilot came to his senses, then helped the young aviator out.

By this time the noise had attracted most of the village. Unfortunately, none of them spoke Japanese, and he didn't speak Hawaiian, so communication was minimal. There were only a few on the island who spoke Japanese. One was a housekeeper, Harada, who'd immigrated with his wife from Japan just a year before.

While waiting for Harada, the locals treated Nishikaichi as an unexpected guest, and certainly the Hawaiian Islands are known for their hospitality. So they threw a welcoming party for him. When Harada finally arrived they still weren't able to get much out of the pilot. So, without anything else to do, they decided to wait until Mr. Robinson, the island's owner, came back on the Monday boat the next day.

On Monday the villagers and their reluctant guest waited at Kie Kie Landing for the weekly boat... but it didn't come. This was unusual, though they had no way of knowing how much the world had changed on Sunday. But the boat didn't come Tuesday. Or Wednesday. Or Thursday. The Navy had stopped all non-essential boat traffic. Mr. Robinson was trapped on Kaua'i.

By this time it was obvious to the islanders that something was up. The pilot had opened up a bit, admitting there'd been a raid on Pearl Harbor, but tried to downplay it. In fact, he told them he was starting to like the friendly isle of Ni'ihau, and hoped to settle down there when the current crisis was resolved.

On Friday morning, with no boat and no news, the natives decided to build a  signal fire. Nishikaichi was left with a man named Haniki, and the 2 went over to visit Harada and his wife.

While they walked, Haniki suddenly found himself held at gunpoint. Harada, at the pilot's request, had stolen a revolver and hunting rifle from the Robinson house. They locked Haniki in a storage room, and headed for Puuwai. The pilot desperately had to get his papers back, as they contained maps and information he'd been told to keep from the Americans.

Running down the road, they horse-jacked a passing cart and rode off for Hawila Kaleohano's home. He was using the outhouse, saw them coming, and ran into the fields. They frantically searched his place, without success.

By this time the village had been emptied, and so the pair began tearing apart all the houses for the papers. They threatened to kill everyone if they weren't handed over. But the only person they encountered was Mrs. Huluolani, an elderly woman who was reading the Bible. She completely ignored their threats, and they finally left her alone.

Giving up for the moment, they stole some tools, ran back to the wrecked Zero, and pulled off its machine guns. Carrying them back to Puuwai, they threatened to shoot up everything until the papers were handed over. But only Mrs. Huluolani heard them. They tore up Hawila's house a 2nd time. this time finding the pilot's pistol, but the papers were still missing. Finally they gave up and burned Hawila's house down, hoping the papers would be destroyed, too (they were actually with Hawila).

The villagers had been watching the events from hiding places outside the town, but weren't in a position to do much. The 2 Japanese men had all the guns on the island. At a strategy meeting it was decided to send women and children to some caves up on the mountain, and the men would try to capture Harada and the pilot while they slept. This didn't work, but a big sheepherder, Ben Kanahali, managed to steal all the machine gun ammo.

By this time the group building a signal fire decided that smoke wouldn't give enough of the details of what was going on. So six of them jumped into a canoe and began rowing the 17 miles to Kaua'i for help.

It took 16 hours of continuous rowing to get there, finally arriving on the afternoon of Saturday, December 13. They found Mr. Robinson, who immediately called the army. A band of soldiers, Mr. Robinson, and the 6 rowers were soon racing back to Ni'ihau on board a lighthouse boat.

But, by the time they arrived late Saturday afternoon, there wasn't much to do. The Battle of Ni'ihau was over.

Ella & Ben Kanahali

Emboldened by his success with the machine gun ammo, early Saturday morning Ben Kanahali decided to go back and steal the other weapons. His wife, Ella, came with him. Because they weren't particularly stealthy they were quickly captured by the 2 Japanese men and taken inside a house.

There the pilot started over with the demands for Hawila and his papers, but Ben said he was tired of the whole thing by now. He told Harada to take the gun away from Nishikaichi before anyone got hurt, but Harada refused.

Ben had had enough. He'd been up all night, was hungry, and felt things had already gone too far. He leaped out of his chair and jumped on the surprised pilot himself. His wife promptly joined in, followed by Harada. The pile of 4 people clawing, kicking, and slugging each other rolled around on the floor for a minute. Harada pulled Ella off, and it settled down into 2 separate fights.

At some point Nishikaichi got his hand free - with the gun - and shot Kanahali 3 times - groin, stomach, and thigh. This, as it turned out, was a mistake.

The gunshot wounds only made the big Polynesian REALLY mad. He calmly stood up from the floor, picked the pilot up by his neck and one leg (he often did this with runaway sheep), and slammed him head first into a stone wall. Nishikaichi was killed instantly. When Ben turned to deal with Harada (who was still struggling with Mrs. Kanahali ), the housekeeper stopped fighting and shot himself.

Thus ended the first, and strangest, land battle of the Pacific war.

In August, 1945, Ben Kanahali was awarded the Purple Heart and Medal of Merit for his part in the action. His wife, sadly, never received any official recognition. He died in 1962, Ella in 1974.

Nishikaichi's ashes were returned to Japan in 1956, when the identity of the invader was finally established. For this reason many early histories of the event (including Walter Lord's excellent "Day of Infamy") name him only as "the pilot."

Years later, his badly damaged Zero was moved to the Pacific Aviation Museum at Pearl Harbor, where it remains today.

Saturday, December 6, 2014

Great online ratings

Thank you, SMOD!

Friday, December 5, 2014


Ms. Healthy: "I'm planning on losing weight."

Dr. Grumpy: "Are you going to follow any type of diet?"

Ms. Healthy: "Yeah, a vegan diet, or Atkins, or paleo. Maybe vegetarian, or South Beach, or gluten-free. You know, one of those diet things. Like the Mediterranean diabetics eat."

Thursday, December 4, 2014

Dr. Grumpy's gift guide

You fart, we all fart. In college, or on guys night out, it can be a source of pride. But, in a crowded elevator, or board meeting, or parole hearing... it may not be the best thing.

Fear no more!

With this simple patch attached to your undies, you can now make them smell like mint!

"What's that smell? I think someone cut the Life Savers."

Now, instead of filling the elevator with noxious fumes, you can gas others with a refreshing blast of mint. The manufacturer (to date) hasn't released other scents (though I think Root Beer, Spring Breeze, and Gingerbread Spice should be considered).

Wednesday, December 3, 2014

Head desk

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Dr. Hospital: "Hi, I was wondering if you got a consult on Mrs. Weirdlastname?"

Dr. Grumpy: "I don't remember, but I got a lot of calls last night. Hang on, let me get my list out."

Dr. Hospital: "I was hoping you could see her soon, because she wants to catch her flight to Calgary later today."

Dr. Grumpy: "Okay, I have my list. How do you spell it?"

Dr. Hospital: "Uh, C-A-L-G-A-R-Y."

Tuesday, December 2, 2014

Brave New World

Source: "Accountable Care Organizations Aim to Provide Better Health Care" Neurology Reviews, September, 2014.

Monday, December 1, 2014

Dr. Grumpy's gift guide

Yes, as the calendar begins its countdown to Christmakuh, it's once again time for the gift guide. Where Dr. Grumpy will help you pick out the finest in tasteful, fashionable, and useful items.

This year, I'm going to kick things off with a solution to a common problem: What to do with a dead rodent.

You've finally killed that pesky mouse that was terrorizing your kids and less-than-impressive dog or cat... but now what? I mean, it seems like a pretty long walk to take it out to the trash can. And after he was kind enough to jump-start your car you really don't want to toss it into the neighbors yard, either.

So why not make it into a lovely decorative piece?

"Well, it beats the leg lamp you imported from Fragilé."

Yes, for only $47 you can give a loved one the complete Mouse Taxidermy Kit. It includes instructions and materials, you just have to supply imagination, props... and, of course, an ex-mouse.

"Do they sell one in St. Bernard size?"

Start a new pastime with the passed-on. It's sure to be a fine conversation piece for a living room, cubicle, or dashboard.

Friday, November 28, 2014

Black Friday deals

Black Friday reruns

Quartzsite, Arizona is a small town along U.S. Interstate 10, and many just stop there for food and gas on the way to other places.

In the local cemetery is a small pyramid with a copper camel on top, marking the grave of a mostly forgotten man named Hadji Ali.

Very little information about his background is known. He was born in 1828 in what was then called Greater Syria (today that includes Syria, Israel, Lebanon, and Cyprus). His parents were likely Bedouins. He was Muslim.

What is known is that he played a central role in what's now a mostly forgotten (but well worth remembering) episode of American and Canadian history.

The idea was first proposed in 1836, but wasn't taken seriously until 1848. Following the Mexican-American war, the United States found itself in control of a large desert, covering what's now New Mexico & Arizona, along with parts of Texas, California, Nevada, and other states. The U.S. Army needed to establish bases and supply lines in the area, both for the border with Mexico and the continuing wars with Indian tribes.

The railroad system was in it's infancy, and there were no tracks through the region. It's part of the largest desert in North America. The only way across was to use horses. But horses, like humans, are heavily dependent on water. This made the area difficult to cross, and vulnerable to attacking Apaches.

So in 1855 Jefferson Davis, then U.S. Secretary of War (later to become President of the Confederacy), put into action an idea proposed by several officers: buy camels to serve in the desert. Congress appropriated $30,000 for the endeavor, and officials were sent to Turkey to do just that.

Between 1856-1857 the U.S. Army bought roughly 70 camels, transporting them from Smyrna, Turkey to Indianola, Texas. To handle them they brought over 8 camel drivers, with Hadji Ali in charge.

The camels worked remarkably well... To a point.

They were perfect for the environment. The huge southwest desert didn't faze them. They led supply trains all over, from Texas to California. With their low need for water, and bodies specially adapted to arid environments, they easily crossed areas where horses and other pack animals couldn't.*

But there were problems. The Americans had envisioned combined forces of camels and horses, each making up for the deficiencies of the other. But horses and donkeys are frightened of camels, making joint convoys difficult and requiring separate corrals. The army was also unprepared for their intrinsically difficult personalities- camels bite, spit, kick, and are short-tempered. Horses are comparatively easy to handle.

With the start of the American Civil War, the U.S. Army Camel Corps was disbanded. Troops and horses were needed on the east side of the country, while camels weren't. Most of them escaped into the desert, and thrived there for a while. In an attempt to preserve them, the Arizona territory  outlawed camel hunting.

But the camel story didn't end there. One of the soldiers, Frank Laumeister, saw business opportunities in Canada. He bought a herd, and in 1862 took them north to British Columbia. The Cariboo gold rush was in progress, and pack animals were needed.

Canadian prospectors and a friend

The results in Canada were mixed. The camels were strong, and could carry twice as much as mules. But their broad feet, while perfect for the sand and dirt of the desert, were cut up by the rocky terrain of the Pacific Northwest. It became necessary to make special protective shoes for them (given their difficult nature, it's unfortunate that history hasn't recorded how they responded to having shoes put on).

The Canadians, like the Americans, discovered they weren't easy to handle. The same problems of difficult disposition and spooking horses came up. In addition, they found camels would eat anything they found. Hats. Shoes. Clothes that were out drying. Even soap. And so, after a few years, the Canadians gave up on the experiment, too.

But they weren't forgotten. A mountain range in British Columbia is called the Camelsfoot. The town of Lillooet has "The Bridge of the 23 Camels". A geographical basin is called "The Camoo".

Some camels were sold to farms. Others escaped into the wild. One was mistaken for a grizzly bear (WTF?) and shot, ending up briefly on a local bar's menu.

The last reliable sighting of a wild camel in Canada was in British Columbia, in the 1930's. The last sighting in North America was in Douglas, Texas in 1941- 85 years after the first ones had landed.

Two fiction movies have been based on the North American camel experiences: "Southwest Passage" (1954) and "Hawmps!" (1976). There's even a folk song called "Hi Jolly!" about them.

And what became of Hadji Ali?

His American hosts had trouble with his name, and pronounced it as a greeting: Hi Jolly! After the camel business shut down he decided to stay here, becoming a citizen in 1880. He tried his hand at several business, and married a woman named Gertrudis Serna in Tucson. They had 2 children. At some point he changed his name to Philip Tedro, but "Hi Jolly" is the name that stuck with him, and is on his Quartzsite tomb.

Hadji Ali and Gertrudis Serna

He prospected around the southwest U.S., occasionally working for the army. Once, when offended that he hadn't been invited to a friend's party in Los Angeles, he broke it up by repeatedly riding through it in a wagon pulled by 2 of his remaining camels.

He spent the last years of his life in Quartzsite, Arizona, dying in 1902. His adventures had impacted 2 countries and covered 3 continents. It had been 51 years since he'd left his native Middle East in one of the strangest military projects on record.

*Technically, it should be noted that camels are originally from North America. Really. Their ancestors evolved in North America 23-40 million years ago, but left. One group went west into Asia (then down to Africa), several million years ago, over the Bering Strait Land Bridge, evolving into today's camels. The rest migrated to South America 3 million years ago when the Isthmus of Panama formed, and became llamas and alpacas.

Thursday, November 27, 2014

Scrolling through Groupon

While I have nothing against vibrators, or Groupon, I did get the giggles over how they're mixed in with more mundane household items.

They were also selling, on DVD, the complete TV series "Highway to Heaven." Regrettably, that pic wasn't next to one of these ads, or it would have been perfect.

Anna and Elsa know what they want for Christmakkuh...

Wednesday, November 26, 2014

Tuesday afternoon

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

Mrs. Concern: "Yes, I need to make an appointment for my husband."

Mary: "Okay, we can see him next Tuesday at..."

Mrs. Concern: "That's not acceptable. We need to be seen urgently, this afternoon. We're flying to visit our children in the morning. It's Thanksgiving this week."

Mary: "Yes, ma'am, but we're entirely booked today and Wednesday, and closed the rest of the week. But next Tuesday we have..."

Mrs. Concern: "We can't wait until then. He's had a stroke."

Mary: "When was his stroke?"

Mrs. Concern: "Sometime during the night. He's had trouble using his left side today, and his speech is slurred. And now my back hurts, because with him like this I had to do all the packing for both of us."

Mary: "Ma'am, you need to take him to the emergency room. I know Dr. Grumpy is going to tell you to do that. Immediately."

Mrs. Concern: "Nonsense. They'll just do some expensive tests and put him in the hospital. We have a flight in the morning, and can't miss that. We're going to visit our children. I just want to have Dr. Grumpy check him over before we leave."

Mary: "You really need to take him to an emergency room."

Mrs. Concern: "Our internist's office told us the same thing. I can't say I like the attitude you people in 'modern medicine' have these days."

Mary: "I'm sorry but..."

Mrs. Concern: "I hope you realize you're ruining our Thanksgiving."

Tuesday, November 25, 2014


This is from a letter an insurance company sent to one of my patients about having an MRI:

So, let's translate this:

1. It's okay with us if you have an MRI.

2. We may pay for it. Then again, we may not. We won't decide until AFTER you actually have it done.

3. If, after we get a bill, we decide not to pay for it, you will have to pay for it.

4. If we do decide to pay for it, you'll still likely have to pay part of the bill. How much this will be will depend on what we decide. We'll let you know after you've already had the test.

5. Once you get the test, you have absolutely no say in the matter. We, on the other hand, can change our mind at any time.

Monday, November 24, 2014

Sunday morning, 3:48 a.m.

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mrs. Wokemeup: "Hi, I'm a patient of Dr. Cortex. He has me on Ataxizon 500mg twice a day. Anyway, for the last week I've had a lot of balance problems. He did labs on Thursday, and said my Ataxizon level was way too high."

Dr. Grumpy: "Okay."

Mrs. Wokemeup: "So he told me to lower the dose to 400mg twice a day. But my balance is still terrible, and I don't know what to do."

Dr. Grumpy: "So you're on 400mg twice a day of Ataxizon right now?"

Mrs. Wokemeup: "No, I take 500mg twice a day."

Dr. Grumpy: "Wait... I thought you said Dr. Cortex told you to decrease the dose because it was affecting your balance?"

Mrs. Wokemeup: "He did. But I wasn't sure if I should. I thought I'd see what someone else thought."

Saturday, November 22, 2014

Home moments

Discovering your kids are playing Star Wars... and have dressed the dog up to be Luke Skywalker.

Friday, November 21, 2014


Dr. Grumpy: "Why are you taking Lithium? Are you bipolar?"

Ms. Valence: "No, I'm Puerto Rican."

Thursday, November 20, 2014

Crystal ball

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

Ms. Seance: "I need to get an appointment right away! I have a brain tumor!"

Mary: "Okay, we have an opening Thursday, at..."

Ms. Seance: "It's an emergency! I have a brain tumor!"

Mary: "Where did you have your MRI? I can try to get that report for the doctor."

Ms. Seance: "I haven't had any tests. Look, this is serious! I have a brain tumor!"

Mary: "Huh? You haven't had any tests? Then how do you know...?"

Ms. Seance: "My medium told me!"

Mary: "A medium told you..."

Ms. Seance: "Yes! And she's never wrong! The spirits told her that I have a brain tumor!"

Mary: "Okay. Well, we can see you Thursday, at 2:30. What insurance do you have?"

Ms. Seance: "CrappyCare, Inc."

Mary: "I'm sorry, we're not contracted with CrappyCare."

Ms. Seance: "But my medium said you are!"

Mary: "We've never been with CrappyCare. Let me give you some phone numbers..."

Ms. Seance: "This is my medium! She's never wrong! You must be!"

Wednesday, November 19, 2014

Elevator talk

It's 5:15 a.m. The first group of docs is drifting in for the day. I grabbed a Diet Coke and got in the hospital elevator. The doors were closing when one of the hospitalists, trying not to spill his coffee, called for me to hold it. So I hit the "open" button.

Dr. Med: "Morning, Ibee. Thanks for getting that."

Dr. Grumpy: "No problem, Jack. Where you starting?"

Dr. Med: "Ummm, I guess 8 would be best. Can you push that? Thanks."

Dr. Grumpy: "Sure. Hey, are you going to send Mrs. Stroke home today? Her dopplers looked fine."

Dr. Med: "Yeah. She's on Plavix, and I'll have her follow-up with you in 2-3 weeks."

Dr. Grumpy: "Sounds good."

Dr. Med: "Recently I've been getting headaches, but only when I'm masturbating. Should I be concerned about that?"

Next time I'm not going to hold the door.

Tuesday, November 18, 2014

Run that by me again

Seen in another doctor's note:

Monday, November 17, 2014

Lunch with Dr. Pissy

Having lunch with a rep selling migraine pills:

Drug rep: "Doctors, did you know that menstrual migraine affects up to 30% of women?"

Dr. Pissy: "And at least ten times that many men."

Pissy's nurse kicked him under the table.

Sunday, November 16, 2014

Weekend reruns

Dr. Grumpy: "You look kind of unsteady today."

Mr. Woodstock: "Yeah, I smoked a few joints out in my car before coming up here."

Dr. Grumpy: "Why did you do that?"

Mr. Woodstock: "I was really nervous about coming in today."

Dr. Grumpy: "Why were you nervous? You've been here before."

Mr. Woodstock: "Oh, not about that. I've been drinking scotch all morning, and didn't want you to notice I was drunk when I came in. I've never been drunk to a doctor visit before, so I smoked some weed to calm down, because I didn't want you to think I'd been drinking."

Friday, November 14, 2014

Land of confusion

Dr. Grumpy: "Are your symptoms any better or worse?"

Mr. Vague: "I'm not sure. Maybe I don't understand what you're asking?"

Dr. Grumpy: "Well, last time you were here we were talking about your leg pain. Does it hurt more or less since then? Or is it about the same?"

Mr. Vague: "That's a really hard question. I'm not sure what you want me to say."

Dr. Grumpy: "Just tell me how your leg feels."

Mr. Vague: "Are there any easier questions? Like what I'm allergic too, or the name of my dog?

No, folks, he wasn't cognitively impaired.

Thursday, November 13, 2014

Happy pills

Dr. Action Potential has made no secret of her battles with anxiety and depression, and the fact that she takes Lexapro.


Absolutely not. I commend her for speaking out on it. Personally, if my doctor has a problem, I'd want them to be getting care for it.

Why do psychiatric disorders get "blacklisted" as a human condition? Insurance companies don't want to pay for them. Employers don't want to give time off for them. Relatives often don't believe in them ("Oh, she just needs to get over it. She's fine.").

The lady who has a heart attack and requires coronary artery bypass surgery gets time off from work, medications and doctors covered by her insurance, and cardiac rehab to help her recover. But the guy who has severe, nearly suicidal, depression? He may get a few days off work by calling in sick ("I have a cold.") He likely won't find help from a psychiatrist because his insurance doesn't cover them, and if he can't afford to pay cash he's SOL. If his boss learns what's really wrong with him he'll probably get fired.

His internist will try to help with some Cymbalta or Wellbutrin, but doesn't have the knowledge on what to do if those fail. Nor does she have the time to spend with him at his appointments because, as a primary doc, she's got a packed schedule.

So let's go back to your doctor being on Lexapro (or whatever) for their mental health. Does this bother you? Why? If your doctor was a diabetic wouldn't you hope they're taking their insulin like they're supposed to? Or blood pressure medication? A doctor who takes care of their own health issues is (hopefully) going to be around longer and capable of practicing better than one with out-of-control blood sugars or hypertension.

Yet, many people who learn their doctor was being treated for a psychiatric condition would probably run like hell from them. Why? If, like treating any other condition, it makes them better able to function, what's the problem? Wouldn't you want that?

Apparently not. Even though doctors battle the same demons as everyone else, AND are in a profession with one of the highest rates of depression and suicide, no one wants to hear that their physician may be on "crazy meds."

Insulin, Sotalol, Coumadin, Xarelto, Amiodarone, Herceptin, Tysabri, Cellcept, and many other potent meds for serious medical conditions - no one cares if their doc takes them. But Prozac? Hell, maybe you shouldn't be in practice.

So here's my confession: I'm on Zoloft (sertraline). I've taken it for 20 years. Don't like that? Think that means I suck as a doctor? I don't give a shit.

I've battled depression since I was a teenager (yes, for the doubting assholes out there, it's a real disease). I also have OCD. Not the personality type, but the actual disorder. Left unchecked, a circuit fires repeatedly in my head causing me to do pointless activities endlessly- checking light switches, counting to certain numbers repeatedly, walking in & out (and in & out) of a room. Those of you who don't face this have no fucking clue how awful it feels to know your repetitive actions are insane BUT YOU CAN'T STOP DOING THEM no matter how hard you try. Imagine being my wife dealing with that.

So, I take Zoloft. It's not a miracle drug for everyone, but in my case it works quite well. It keeps my wife from killing me for flipping the lights, or shower, or whatever, on & off too many times. It lets me focus on figuring out what's wrong with you, or playing basketball with my daughter. Got a problem with that? Go find another neurologist.

We might treat you for a mental illness, and wouldn't hold it against you, so why would you hold it against us? Or a lawyer, or decorator, or veterinarian, or politician (there's a lot you CAN hold against politicians, but this shouldn't be one of them), or plumber, or nurse, or accountant..., or anyone else for that matter?

I also take Lipitor for my cholesterol. Does that bother you? I doubt it. But I bet Zoloft would make you think twice about coming to see me. Why?

Your doctor, like me and Action Potential, is just another person, made up of the same organic chemical soup as you. We're going to have the same issues that you face (given the nature of this job, possibly more). And if we're willing to be treated for that, I personally think that's good. It let's us concentrate on taking care of you.

Which is, after all, why you came to us.

Your doctor can't help you unless they take care of themself first. No matter what their health problem is.

Wednesday, November 12, 2014

Mary's Desk

Mary: "Okay, so we have you down for next Tuesday, at 4:15."

Mr. Argue: "I'll be there. This is so exciting! I've always been stuck seeing general neurologists, and I'm so thrilled to finally be seeing someone at the famous Binswanger's Clinic."

Mary: "Um... we're not part of the Binswanger's clinic."

Mr. Argue: "Of course you are. The person who gave me your name said so."

Mary: "No... The Binswanger Clinic is in south Grumpyville, about 5 miles from here."

Mr. Argue: "But I want to be seen by a Binswanger neurologist!"

Mary: "Okay, but Dr. Grumpy isn't part of that institution. We're happy to see you here, but we don't have any affiliation with them."


Mr. Argue: "Then cancel my appointment. I'm tired of settling for neurologist wannabes."

Tuesday, November 11, 2014

Veterans Day, 2014

Corporal Chester Nez, U.S.M.C.

Buried under headlines full of election-year vitriol, fighting in the middle east, conflict in Ukraine, ebola, comments by a basketball team owner, nuts with guns killing police officers and civilians, religious nuts with bombs killing anyone they can, and other cheery items... were 2 obituaries. Odds are that they didn't even make it into your local paper, or newsfeed, and even if they did you probably skipped them.

On June 4, a 93 year-old man died in Albuquerque of kidney failure. He was born in 1921 in Chi Chil Tah, New Mexico. Never heard of it? Join the club. It's an unincorporated area of land on an Indian reservation in western New Mexico. He could have been anyone's father, or grandfather, or great-grandfather, from that remarkable Greatest Generation.

But Chester Nez was so much more.

He was the last living member of a group of 29 men who were critical to the Allied victory in WW2.

They were the original Navajo Code Talkers.

You've likely heard the story to some degree. American forces needed an unbreakable code to fight their way across the Pacific. There was a successful one already in use, but it required a long time to transmit, receive, and decode at the opposite ends. And time, in the rapidly changing situation of combat, is one thing you don't have.

The U.S. had used Choctaw and Cherokee code talkers, with great success, in WWI (you probably didn't know that, either. Maybe I'll tell that story another time). In the buildup to WW2, however, the Germans were aware of this and sent anthropologists to the U.S. to learn as much about the native languages as they could. As a result they were used only on a small scale in Europe, with Comanche and Meskwaki talkers serving at Normandy and in Africa, respectively. Seminole talkers served in both Europe and the Pacific.

Navajo is a complex language. As of 1942 it hadn't even been set on paper, and was only known through oral teaching. It has a different grammar structure from other North American native tongues, and is indecipherable for those not familiar with it.

Philip Johnston, who'd been raised on the reservation in a family of missionaries, was one of the rare non-native speakers. In 1942 he approached the army with the idea, and they began quietly recruiting Navajo men. In tests under simulated battle conditions they found the talkers could relay an operational message in 30 seconds - compared to roughly 30 minutes using the standard encode-and-decode system. The cipher they finally developed was an odd combination of phonetic alphabet, straight words, and approximations (for when there wasn't a Navajo equivalent for English). Bombers became buzzards. Submarines were iron fish. Tanks were tortoises.

Codebooks to teach the new system were developed, but carefully watched and never left classrooms. Testing by U.S. codebreakers unfamiliar with Navajo showed that, to a non-speaker, it was unintelligible gibberish.

The Navajos were rapidly deployed. At Iwo Jima, home of one of the world's most iconic photographs, 6 code talkers operated continuously for 48 hours. They called in fire support, updated positions, relayed new orders, and allowed the commanders to quickly adjust to changes ashore. Major Howard Connor, commanding the Marines' signal division, later said that, without the Navajos, the island wouldn't have been taken.

It remains, to this day, the only spoken code that was never broken.

Not that the Japanese didn't try... Early in the war, at Corregidor, they captured Joe Kieyoomia, a Navajo serving in the army. Joe subsequently survived the Bataan Death March. He was viciously beaten by the Japanese, who thought his facial features meant he was of Japanese descent, and therefore a traitor. Eventually he was put in a concentration camp outside Nagasaki with other soldiers.

When the Japanese suspected the code was an Indian tongue, they tried to have Joe translate for them. He recognized the words, but since he didn't know the arranged structure and phonetics he couldn't understand it. As a result they tortured him even more viciously, then made him stand naked in snow. His feet froze to the ground, and when they shoved him back to his cell, the soles tore. Somehow surviving that... he went on to live through the atomic bombing, too. He died in New Mexico in 1997, and you probably didn't see his obituary, either.

Edmond Harjo, the last surviving Seminole code talker, died this year, too, on March 31, 2014. He was 96. He served in more territory than most, sending and receiving messages at both D-Day and Iwo Jima.

And the man I started the article with, Chester Nez, returned after the war and eventually became a painter at the Veterans' Hospital in Albuquerque. When he died on June 4, 2014 he was the last survivor of the original Navajo code talkers, who served with such great distinction far from home.

Monday, November 10, 2014

The nature of medicine

On call this past weekend, I was down in ER. They brought in a young guy who was killed in a bar fight. Massive head injuries. There was nothing that could be done.

And he was wearing a green T-shirt with a picture of a shamrock on it, that said "Today is my lucky day!"

A nurse commented this is the only field on Earth where such things are funny. She's probably right.

Friday, November 7, 2014

Question of the week

"Doctor, how do I know if I'm having a headache?"

Thursday, November 6, 2014

I'm just here for the knives

Seen in a surgeon's note:

Thank you, Glen!

Wednesday, November 5, 2014

November, 1932

This week in 1932, a war was fought... One that would see the Australian military suffer what may be the most bizarre defeat in the history of armed conflict.

In the midst of the worldwide depression, Australia's Summer wheat crops were attacked by a marauding hoard of roughly 20,000 emus. The birds found it was easier to eat grain off cultivated rows than forage for it, and settled in.

"Our ancestors were Tyrannosaurs. Who's going to stop us?"

Emus are not small objects. After its cousin, the ostrich, it's the second biggest bird on Earth. They can't fly, but can kick viciously and run at over 30 mph. Their claws easily shred wire fences, and they're big enough to jump over or knock down most wooden ones. They can grow to a height of 6'6" and weigh up to 125 lbs.

In summary, they're not going to be threatened by a scarecrow. Or much else.

The farmers appealed to the government, and the Minister of Defence, Sir George Pearce, felt this was an excellent way of both assisting the farmers and getting his troops some target practice. Machine guns had helped break the Western Front stalemate in 1918, so would be ideal for mowing down a few overgrown sparrows.

They were just birds. What could possibly go wrong?

Major G.P.W. Meredith of the Royal Australian Artillery was the man tasked with boldly leading the expedition. He was given a group of soldiers armed with the latest machine guns, plenty of ammo, and orders to eradicate the birds.

He was also told to bring the feathers back for hats.

Upon arrival, the farmers and Major Meredith set up an ambush, hoping to kill most of the birds in one stroke. The farmers drove the huge flock toward where the soldiers were hiding... Only to have the emus break up into multiple small groups instead of staying in a large one.

Out of thousands, the machine guns killed... only 12 birds. More were wounded, but the soldiers found that shooting an emu didn't necessarily slow it down. In fact, anything short of hitting a vital organ just made them mad.

"Don't fuck with us, you overgrown monkeys."

Undeterred, Meredith courageously set up another ambush, this time cornering roughly 1000 birds near a dam. His men opened fire at close range... again with only 12 dead birds after much shooting. And one of the pricey machine guns broke.

An ornithologist later wrote that "The machine-gunners' dreams of point blank fire into masses of emus were soon dissipated. The emu command had evidently ordered guerrilla tactics, and its unwieldy army soon split up into innumerable small units that made use of military equipment uneconomic." In other words, the birds quickly scattered, and were damn near impossible to hit.

With the marauding emus showing no signs of leaving, Meredith changed tactics. In a burst of inspiration (likely from that great American strategist Wile E. Coyote), he borrowed a truck from a farmer, mounted a machine gun on it, and sent it racing into the flock

Sounds like something from a comedy flick at this point, huh?

"Trust me. I'm a professional."

To the Major's horror, the birds were easily able to outrun the truck. And, as they drove over the uneven landscape, the vehicle bounced so much that his men were unable to aim, or even properly work, the gun.

This experiment in motorized warfare came to an abrupt end when a heroic kamikaze emu turned around and ran directly into them. It's body jammed the suspension, causing the truck to spin out of control and destroy a farmer's fence. History didn't record who paid for the damages.

After a few days of similar front-line combat, Major Meredith sent a report estimating 200-500 birds killed, though the number was likely closer to 50. He also credited his opponents, who were able to keep running in spite of multiple wounds. "If we had a military division with the bullet-carrying capacity of these birds it would face any army in the world" he wrote. "They can face machine guns with the invulnerability of tanks."

He also noted that his own forces had suffered no casualties.

One soldier later gave this assessment of the enemy's strategy: "The emus have proved that they are not so stupid as they are usually considered to be. Each mob has its leader, always an enormous black-plumed bird standing fully six-feet high, who keeps watch while his fellows busy themselves with the wheat. At the first suspicious sign, he gives the signal, and dozens of heads stretch up out of the crop. A few birds will take fright, starting a headlong stampede for the scrub, the leader always remaining until his followers have reached safety."

The good Major withdrew in defeat, but was ordered back. This time his forces were somewhat more successful in culling birds... But still unable to seriously dent their numbers, or get them to leave the area. Some basic number crunching found that, on his best day, it took an unsustainable amount of costly ammunition to bring down 1 emu. It was a war of attrition, and the emus had the numbers. Faced with being beaten by birds, Defence Minister Pearce ordered a withdrawal and wished the farmers good luck.

Eventually, as news of the heroic military operation got around, there was a debate in the Australian government. It featured this memorable exchange:

Mr. Thorby: "Who is responsible for the farce of hunting emus with machine guns mounted on lorries? Is the Defence Department meeting the cost?"

Prime Minister Lyons: "I have been told the Defence Department will not be paying the bill."

Mr. James: "Is a medal to be struck for this war?"

Another minister later commented that if such a medal were struck, it should be awarded to the emus.

Although the farming community would request military intervention against the birds in subsequent years, the lesson had been learned and no further emu wars were launched.

Today, along with the kangaroo, the emu is one of Australia's national symbols, showing just which side came out ahead in the brief conflict.

"Primates! You know where you can stick your opposable thumbs?"

Tuesday, November 4, 2014

Overheard in ER

Nurse 1: "I need another urine sample cup for room 17."

Nurse 2: "Didn't you just give him one?"

Nurse 1: "Yeah. I gave him the cup and a Betadine swab. I told him to wipe himself first, then put it in the cup. So he wiped his dick with the swab, then put the swab in the cup."

Monday, November 3, 2014

Halloween memories - epilogue

For those wondering after reading Friday's post...

This, in memory of my grandfather, is the tie I wore. He bought it as an honest-to-God ordinary tie that he wore to his job. It is truly one of my most prized possessions, because, let's face it, ties this hideous aren't easy to find.

Sure, you can buy lots of gag ties that are intentionally horrid, but what makes this thing so awesome is that someone designed it in the 60's-70's as a serious tie for men to wear to business meetings, Bar Mitzvahs, whatever. And my grandfather paid good money for it and DID JUST THAT.

The day I found it in his closet, I knew I'd stumbled on something rare and worth keeping. Someday I'm sure one of my descendants will do the same.

The picture doesn't do the bright colors justice. The vibrant reds, oranges, pinks, yellows, golds, whites, and a few previously undescribed hues make a pattern so striking... It looks like Roy G. Biv threw up.

Also, it's so wide at the bottom that you could wear a midriff shirt and no one would notice.

Yes, I really did wear it to work. Be jealous.

Friday, October 31, 2014

Halloween Memories

A long time ago, in a medical office building far, far, away...

As my regular readers know, before I went solo I worked for a large group called Humungous Neurology, Incorporated (HNI).

I left them for a lot of reasons, one of which (as is usually the case) was money. I won't go into too many details, but when I left my "contract-guaranteed" salary had been slashed by roughly 75% (to less than I'd made as a resident) because the money was needed for "the research budget."

By coincidence, my last day working for HNI happened to fall on Halloween.

So that day I came to the office (with a full schedule of patients) wearing an old pair of pants that I'd used to paint the house, a shirt with holes in it, a sock on only 1 foot, a pair of badly mismatched rundown shoes, and, for the pièce de résistance, this horribly hideous 70's era tie that I found while cleaning stuff at my grandparents' house.

When people asked me what my costume was, I told them I was an HNI neurologist, who couldn't afford decent clothes.

Thursday, October 30, 2014

Repeating oneself... a symptom of...

Medication list from a patient (highlights added).

For those not in the medbiz, Donepazil is used for Alzheimer's disease.

Thank you, Gary!

Wednesday, October 29, 2014

Skool Nerse time

This is Mrs. Grumpy.

Kid wanders into my office.

Nurse Grumpy: "What's up?"

Kid: (wailing) "I was playing in the sandbox and got sand all over my hands and under my fingernails!"

Nurse Grumpy: "Have you tried washing your hands?"

Kid: "Ummm... No."

Nurse Grumpy: "Go wash them in my sink over there. Use soap."

(Kid washes hands)

Kid: "It's all better now!"

Nurse Grumpy: "Okay, go have fun."

Kid: "I'm going back to the sandbox. What a neat trick!"

Tuesday, October 28, 2014

Doctor's lounge, Sunday morning, 6:18 a.m.

Cardiologist: "The coffee machine is broken."

Neurosurgeon: "Ah shit. I really needed some, too."

Neurologist: "I don't think they come in on weekends to fix it, either."

Pulmonologist: "They don't. We're fucked."

Cardiologist: "Maybe we can do something..." (Opens front of machine).

Neurologist: "Wow, what a mess."

Neurosurgeon: "I think this thing that fell over holds the used grounds."

Neurologist: "Yeah." (dumps grounds in trash, rinses holder in sink, puts it back in machine).

Nothing happens.

Pulmonologist: "It's still not working."

Neurosurgeon: "Let me see... Here, look. The part that feeds the filter paper roll got doubled up and twisted. It's stuck."

Neurologist: "Hang on..." (pulls out filter paper roll) "Ah, okay, looks like it wasn't put in correctly. Let me turn it around and toss the jammed paper."

Machine starts gurgling.

Pulmonologist: "It's working! Yay! Coffee!"

(All get coffee)

Cardiologist: "That's amazing."

Neurosurgeon: "The coffee gadget?"

Cardiologist: "No. For the first time in medical history it was a neurosurgeon who made the correct diagnosis, and a neurologist who fixed it."

The pulmonologist blew her coffee all over the bagels.

Sunday, October 26, 2014

Dog WIN!

Saturday, October 25, 2014

Christmakuh is coming

So, if any of you guys have horrifying gift ideas you'd like to submit for this year's catalog, please send them in!

Friday, October 24, 2014

It's just a jump to the left

Seen in a cardiologist's hospital dictation:

Thursday, October 23, 2014

Dear American Medical Association,

Thank you for the brochure I received from you and Mercedes-Benz, making me aware of the great car deals available to physicians.

I'm glad to see the AMA is still living in some sort of fairytale land where doctors have money trees growing in their yards. This sort of stereotype only fuels the already crappy image the public has of us.

Here's the reality: In 2013 (my worst year ever, due to several factors) Dr. Grumpy's solo practice salary came out to $99,354. That's working 60-70 hours per week, with 4 weeks of vacation.

Now, I'm NOT (emphasize NOT) complaining or bragging. I'm just stating this as a fact, to make a point. I know there are MANY people who'd be grateful to be able to make that. I'm thrilled to have a job I like that allows me to support my family.

But the reality is this: I drive a 14 year-old Nissan Maxima with the passenger door smashed in. Sending me a booklet telling me that, as a "qualified physician," I can save $1000 off a $92,000 S-Class sedan, $3000 off a $72,100 CLS-Class coupe, $4000 off a $116,000 CL-Class coupe, $3000 off a $114,200 G-Class SUV, or $3000 off a $106,700 SL-Class roadster... just shows me how fucking incredibly out-of-touch you guys are with the reality facing today's doctors.

Granted, I'm not a member of your organization. Honestly, I'd rather spend the $420 annual fee on my kids. To the best of my knowledge, an AMA membership gets me a journal I don't have time to read, discounted admission to an annual meeting I won't go to, and, obviously, a token discount on a car I can't afford. In fact, if I was a member, I'd be pretty pissed to find out this is what you were spending my annual fees on: getting me a deal on an imported car that costs more than I made last year.

American medicine is in a serious crisis right now. I'm not going to take political sides, as there are plenty of blogs for that. But my point here is that you guys are obviously clueless as to how much docs are really making.

Not to mention medical students. The next generation of docs are coming out of school $200,000 in debt. Residency pays maybe $40,000 a year, and they're at the ages where they're starting families, buying first homes, etc. Then they get to go earn practice salaries that (like mine) are dropping each year. So realistically the only "luxury automobile" they'll get to ride in... is a hearse.

Note to medical students- if you're doing this thinking you're going to get rich, just stop now and cut your losses. In fact, I'd get out regardless of why you're doing this.

But, I'm glad to see you AMA guys are on the ball. I'm sure there are SOME doctors out there who can blow that kind of money on a car (likely all on your board of directors) and it's reassuring to know you're doing something to benefit them.

The rest of us hard-working docs trying to practice ethical front-line medicine will stick with our old cars with the sides smashed in.

Wednesday, October 22, 2014

With a capital E

Mrs. Eword: "So, anyway, I want an MRI, and can do it today."

Dr. Grumpy: "I agree with getting one, but your insurance requires a pre-authorization. I'll have my staff get started on that, but it takes a few days and..."

Mrs. Eword: "I don't think you heard me. I want it NOW. While I'm here."

Dr. Grumpy: "Well, it has to be scheduled with an MRI facility and your insurance. I don't do them here."

Mrs. Eword: "What do you mean you don't do them here? You're a neurologist, aren't you?"

Dr. Grumpy: "Yes, and I order MRI's, but don't have the machine in my office. We use Local MRI, across the street and..."

Mrs. Eword: "I cannot believe this. What's that room I passed with the door closed down the hall here? There was a lot of noise. Isn't that your MRI?"

Dr. Grumpy: "Uh, that's the bathroom. They're replacing the sink's pipes today."

Mrs. Eword: "So you've been wasting my time this morning. Doesn't other peoples time mean anything to you? This is incredibly inconsiderate."

Dr. Grumpy: "I..."

Mrs. Eword: "I'll go elsewhere." (gets up, leaves)

Tuesday, October 21, 2014

Bite me

The kids had a healthy breakfast of Costco chocolate muffins yesterday, one of which had a minor defect.

But they felt the need to text it to me:

Monday, October 20, 2014


I'm with a patient, when Mary knocks on my office door.

Mary: "Dr. Schnozz is on the phone, says he needs to talk to you ASAP."

Dr. Grumpy: "Excuse me..." grabs phone "This is Dr. Grumpy."

Dr. Schnozz: "Hi, we have a mutual patient, Mr. Platelet, and he was here with his wife a short while ago for his sinuses. Anyway, I'm concerned he needs you to work him in urgently."

Dr. Grumpy: "What's up? I mean, he was just here this morning at 9:00."

Dr. Schnozz: "Really? They didn't mention that. Anyway, he's weak on his left side, and I'm worried he had a stroke."

Dr. Grumpy: "He DID have a stroke. I had him in the hospital last week for it, and I saw him today in follow-up. He's weak on the left, and I ordered physical therapy."

Dr. Schnozz: "They didn't tell me that either. Never mind."

Friday, October 17, 2014

Memories... part 3

Dr. Tallahatchie went home. Because he was unable to use stairs for several weeks, and his apartment building didn't have an elevator, he needed to find a place to stay that was on the first floor.

Which, as it turned out, was my apartment.

So, 3 of us went to his place to haul crap he needed for a few weeks to survive, like some clothes and CD's, over to my abode.

As he waited in the car, he suddenly realized he'd forgotten to tell us to get something else he needed: his comic book collection. So, grabbing his crutches, he got out and hobbled over to the staircase. Since we didn't respond to his yelling, he decided to try ascending a few stairs... and fell. Landing on his recently broken leg.

The leg, fortunately, was covered in such a huge cast that it was indestructible. But it still hurt like hell. We ran down the stairs to help him back up.

He was pale and looked quite uncomfortable. Without saying a word he reached into a pocket and pulled out the newly-filled bottle of Percocet we'd just picked up. He poured several into his mouth, chewed them up and swallowed, then hobbled back to the car.

All he said then was "Wake me when we get to your place."

Thursday, October 16, 2014

Memories... part 2

Dr. Tallahatchie, as anticipated, required a fairly lengthy surgical procedure. He'd broken his leg in 3 places, 1 of which was a compound fracture.

Even worse (from his view) was that they wouldn't let him smoke.

Recovery from this sort of thing is not painless. After surgery he was put on a morphine PCA pump. For those of you not in medicine, this is a gadget that delivers IV narcotics controlled by the hospital patient. You need more morphine? Press a button and it gives you some. The pump is programmed with a maximum amount and frequency you can receive, and is locked out with a security code.

20 years ago, however, the security codes were only 4 digits, and Dr. Tallahatchie had a photographic memory. After watching the nurse set it up, it took him only a few tries to hack it. Due to ongoing pain, he increased his morphine dose. This made him much more comfortable.

Nursing found him still breathing, but unable to be woken. The internal medicine service, comically, called for a neurology consult, and my colleague, Dr. Violet, told them exactly what the problem was.

So they took his PCA pump away. Since his vital signs were okay Violet didn't have the heart to use Narcan.

As a result of the overdose, the good doctor was now unable to pee, and so a foley catheter was ordered. His nurse started the procedure, only to be stopped when Dr. Tallahatchie suddenly became wide awake, sat-up, and yelled "HEY! THAT'S MY WINKIE!!!"

Although now more alert, he still couldn't run the water. And when the nurse came at him with the foley again, he asked her to give him a few minutes to "prepare himself."

She stepped out, and he frantically paged me, asking me to bring him a pair of sterile size 7 gloves. He didn't say why, but I realized what was up when I got there. He took the gloves and told me to distract the nurse for 5 more minutes. He wasn't going to let anyone touch his winkie.

When the nurse came back, she was stunned to see he'd put it in himself. Correctly.

Note: As of yesterday, Dr. Tallahatchie confirmed that (20 years later) he still smokes and drinks. He has not, however, attempted climbing a tree again.

Wednesday, October 15, 2014

Memories... part 1

One summer, a bunch of us neurology residents volunteered to work at a summer camp for teenagers with epilepsy.

This went well. Until the last day.

After the kids' bus had left, we learned the van coming for us had a mechanical issue, and would be delayed 4-5 hours.

So, with nothing better to do, we walked a mile to the nearest town, bought a shitload of cheap beer to carry back to camp, and got drunk. For those of you who are horrified, this is pretty standard. Medical residents are basically college students, but with more letters after their names.

This went well until our chief resident (Dr. Tallahatchie), the one in charge of showing us younger residents the proper way to do things and to lead by example... Decided to climb a large tree. This kind of decision (and the inevitable "Hey, everybody, watch this!") always seems to follow alcohol consumption. Especially when the person involved grew up in rural Mississippi.

In a bold display of intoxicated coordination, Dr. Tallahatchie climbed a tree about 15-20 feet up, then tried to swing across to a branch on it's neighbor. Which broke.

When we got to him, our chief resident was awake, still drunk, and had a broken bone sticking out of his right leg. The excessive alcohol probably helped, as he absently commented "boy, I sure fucked that up." He then pulled out a pack of cigarettes, began smoking, and pulled my beer out of my hand and finished it.

So we had several highly-trained medical people standing around, with no clue what to do for a compound fracture. I mean, if he'd had a stroke, or seizure, we might have had an idea. But we're neurologists, and don't know a damn thing about bones. None of us had a phone, either (this was the mid-90's) and the camp's office was locked. So, we threw some T-shirts on to absorb the blood, and Dr. Linn (who ran marathons often) bolted back to town to call an ambulance.

She also bought more beer.

When the paramedics arrived, they asked Dr. Tallahatchie to stop smoking for the ride back to Big City Hospital. He refused, and said he knew he'd be in the hospital for the next week and wouldn't be allowed to smoke there, so was going to keep puffing until they rolled him into ER. The sympathetic medic said "okay" and offered him a light. His partner went into the back of the truck to make sure their oxygen tank was closed and secured.

Our van didn't show up for another hour. We took Dr, Tallahatchie's suitcase with us. It was mostly full of comic books, which we read to pass the time.

To be continued...

Tuesday, October 14, 2014

Skool Nerse time

This is Mrs. Grumpy.

Last week I had a sick 7 year old girl in my office. While she was waiting for her aunt to come get her, I was reading some reports and swearing at them.

Nurse Grumpy: "Oh, Jeez! What's does this mean?"

Daisy Mae: "NURSE GRUMPY! You shouldn't swear like that!"

Nurse Grumpy: "Huh?"

Daisy Mae: "You said part of a word you're not supposed to say!"

Nurse Grumpy: "Oh, sorry, Daisy Mae."


Daisy Mae: "Nurse Grumpy?"

Nurse Grumpy: "Yes?"

Daisy Mae: "I guess it could have been worse."

Nurse Grumpy: "I'm sure."

Daisy Mae: "I know the 'F' word."

Monday, October 13, 2014


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

Mrs. Cephalgia: "Hi, I'm a patient of Dr. Grumpy's, and want to go off my migraine medication. I haven't had a migraine since I reached menopause, and don't think I need it anymore."

Annie: "Okay, let me open your chart... When did you become menopausal?"

Mrs. Cephalgia: "Tuesday."

Sunday, October 12, 2014

Weekend reruns

Dr. Dickweed is an internist upstairs from me. He's been there since I moved into the building in 1997.

He's never referred to me. I'm polite. I've tried to talk to him in the elevator. When I started out years ago I went by his office asking for referrals. He coldly informed me that he doesn't trust, or refer to, physicians under 60 years old. Whatever. He's entitled to his opinion.

Anyway, Mary interrupted me today to say that Dr. Dickweed was on the phone. This was a first, so I picked up the phone.

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

Dr. Dickweed: "Grumpy, this is Dickweed. I just want you to know that I'm out of Grizzitor samples, and one of my patients needs some. I told her to come by your office to get them. Your staff doesn't need to schedule her for an appointment, and you don't need to see her. Just give her whatever Grizzitor samples you have."

Dr. Grumpy (somewhat taken aback by this kind request): "Dickweed, I'm out of Grizzitor samples. They stopped sampling it years ago."

Dr. Dickweed: "You young doctors are so fucking worthless." (click).

Friday, October 10, 2014

Quote of the day

"I'm allergic to all organisms that grow out of the ground."

Thursday, October 9, 2014

Wednesday night, 10:27 p.m.

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mr. Molosser: "YEAH! You saw my daughter last week, she's in college up there, and I CAN'T BELIEVE WHAT YOU PRESCRIBED FOR HER MIGRAINES!!!"

Dr. Grumpy: "Um, sir, Migragone is a common treatment for migraines. It's been around for almost 20 years, and is pretty standard."

Mr. Molosser: "DON'T TELL ME THAT! I know medications! It's dangerous! It's experimental! I told her not to take it!"

Dr. Grumpy: "Are you a doctor?"

Mr. Molosser: "No, I manage a White Castle. And I'm having her find another neurologist. NOBODY treats my beautiful daughter like a guinea pig!"


Wednesday, October 8, 2014

Parental abuse

My mom recently updated her phone to iOS 8, and texted to let me know.

Tuesday, October 7, 2014

"Those better be some damn fine scrubs!"

Seen on Amazon:

"Not just polyester and rayon, they're ARTISANAL polyester and rayon."

Thank you, Helle!
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