Monday, August 21, 2017

Seen in a chart

As opposed to?

That's all the line said about it, folks. I didn't cut anything out.

Thursday, August 17, 2017

My readers write

A 2nd year internal medicine resident sent this in:

I was doing night admissions, and one was an elderly lady who'd come in for a hip fracture. The ER doctor told me the ortho surgery resident had already seen her, but there was nothing in the chart to tell me what the plans were.
So I called the ortho resident to touch base.

Dr. Dudebro: "Ortho, returning a page."

Me: "Hey, I'm the medicine resident admitting Mrs. Hip. You evaluated her in ER a few minutes ago?"

Dr. Dudebro: "Oh yeah, with a broken hip! What's up?"

Me: "What's the plan for her?"

Dr. Dudebro: "Uh...she needs surgery."

Me: "Right, but what's your plan? When are you planning to take her?"

Dr. Dudebro: "Uh...I don't know. She needs surgery."

Me: "Okay, but she's on Coumadin and is therapeutic. Are you taking her to OR tonight, and I need to reverse her ASAP? Or is this less urgent, and I can just give her vitamin K and manage her pain until you're ready for her?"

Dr. Dudebro: "Uh...she needs surgery."

Me: "Never mind. I'll figure it out."

- Thank you, R!

And for those of you who remember:

Tuesday, August 15, 2017

Summer fun

I'm at work.

Mrs. Grumpy is out of town with the twins.

Frank is at home alone. He's 17, so should be able to survive for a few hours on his own, right?

Then, while I'm with a patient, this text from him shows up:

Friday, August 11, 2017

Breaking news!

From around the world, Dr. Grumpy's reporters bring you the stories that shape our lives.

DATELINE: Durango.

A bear broke into a parked Suburu SUV and took it for an early-morning spin.

The unidentified ursid, who's still on the loose, smashed a window and climbed in. From there it released the parking brake and went rolling down the street.

During its brief ride the bear drove over some utility boxes before finally going into a yard and hitting a mailbox. The homeowner, Mr. Ron Cornelius, was woken by the noise and called police. When asked about the early hour, Mr. Cornelius said "Usually, I don’t get up at 5 o’clock unless there is a bear driving a car down the street."

Apparently unhappy about its short ride, the bear destroyed the interior of the vehicle. It pulled the steering wheel off the shaft, ripped the radio out, and broke the back window.

Originally it was thought to have been the work of human vandals, but the bear's involvement was confirmed by the extensive degree of damage wrought and, more importantly, a large pile of bear shit that had been left inside the car.

So there you have it: Bears do shit in the woods, but in a pinch will use a Subaru.

DATELINE: Olympia.

A traffic jam was caused by a dead body rolling down the street.

Police said an ambulance transporting a dead body had its back door open while moving. Two gurneys, one with a recently deceased occupant, fell out and went speeding down the street.

The driver, unaware of this turn of events, continued on his way.

The gurney with a body stopped in an intersection, forcing police to re-route traffic through the area until coroner's staff could arrive to take the escapee into custody.

The empty gurney was found in a parking lot.

Neither gurney, nor the deceased, was damaged during the joyride.

DATELINE: Sioux City.

Police were called when a man attempted to deposit a fake $1 million dollar bill into his bank account.

Upon arriving to the bank, police officers interviewing the fellow asked if he had any more of the million dollar bills on him, whereupon he pulled a bag of methamphetamine out of his pocket.

Somewhat comically, he's being held on a $1,000 bond.

Police suspect drugs were involved.

Wednesday, August 9, 2017

"It's for the neurologist. You know how he can be."

A nurse writes that, when she arrived to work yesterday, this was the state of the galley fridge at her ICU:

Thank you, J!

Monday, August 7, 2017

Annie's desk

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

Lisa: "Hi, this, is Lisa, referral person for Deathtrap HMO."

Annie: "Hello."

Lisa: "Dr. Grumpy referred Mr. Axon to Dr. Needlemeister for an EMG? I thought Dr. Grumpy does these himself."

Annie: "He does, but Mr. Axon has a number of issues that make the test more complicated. So Dr. Grumpy prefers that an EMG specialist do it in this case."

Lisa: "Okay, but if Dr. Grumpy has another doctor do it, I want to make it clear that we will not pay Dr. Grumpy for the test. We'll pay that doctor instead."

Annie: "Of course. We wouldn't expect you to pay us for it."

Lisa: "You people are so weird."

Thursday, August 3, 2017

Covering all the bases

Seen in a chart:

Thank you, C!

Monday, July 31, 2017


It's Saturday afternoon. As I'm heading home from the hospital, Mrs. Grumpy texts me to get some tomatoes at the grocers and to pick up my Sarcasma at the pharmacy before she has to kill me.

I'd been at Marie's basketball game when the hospital called, and so was wearing an old Motörhead T-shirt. While waiting in line at the grocery store some guy came over.

Some Guy: "Hey, I like that T-shirt."

Dr. Grumpy: "Uh, thank you."

I'm generally not one for small talk, so stared at my iPhone and began checking email. Unfortunately, this didn't stop him.

Some Guy: "I'm a big Motörhead fan. I saw them in person back in the day."

Dr. Grumpy: "Cool."

Some Guy: "I love their stuff. I was busted up when Lemmy died. You know, I don't think I've ever seen that particular T-shirt. Where'd you get it?"

Dr. Grumpy: "Uh, don't remember." (Actually, I'm pretty sure I got it at the charity thrift store for $1)

(I texted Mary asking her to call me so I can answer my phone)

Some Guy: "How much do you want for it?"

(He didn't really say that, did he? I'll just keep staring at my phone.)

Some Guy: "I like it. How much do you want for it?"

(For a fleeting second I think about it. I paid $1 for it... Ask him for $40 and see what he says.)

Dr. Grumpy: "No, thank you. Then I'd have nothing to wear home, and I still have errands to run."

Some Guy: "That's easy. I'll give you mine."

I look at him. He's wearing a white wife-beater undershirt with food stains and probably more antibiotic-resistant organisms than an uncleaned colonoscopy tube.

Dr. Grumpy: "Uh, no thanks."

(Mary texts me back, asking how much a call is worth to me)

Some Guy: "Your loss, dude."

He walks off. I got the tomatoes and headed over to the pharmacy. While in line there...

Some Guy: "Hey! It's you again. Did you change your mind? I came by to get some condoms. I'm still willing to switch shirts."

Dr. Grumpy: "No, thank you. I'll keep this one."

(The other people in line are looking at both of us like we're street performers)

Some Guy: "I've got a sort-of cleaner T-shirt in my car, I'll throw that one in, too."

Pharmacist: "Next in line, please."

It's my turn. Thank heavens.

Sunday, July 23, 2017

Back next week!

We're still dragging kids around (and vice versa).

Sunday, July 9, 2017

Off, again

Heading out for our big trip of the summer.

3 kids, lots of relatives, and our credit cards.

See you in a few weeks!

Wednesday, July 5, 2017


Back in residency, I occasionally had to round with Dr. Levodopa on weekends.

Dr. Levodopa, in a field of pathological personalities, had more odd mannerisms than I could count. But his strangest was that he carried a cup of black coffee... in his white coat pocket.

Not a travel mug, or even a generic cup with a plastic lid on it. But an open styrofoam cup. He'd fill it about 3/4 to the top at the nurses station, take a few sips, shove it in one of the coat's lower pockets, and start rounds.

So he had a large collection of white coats, all with dark coffee stains running from the right front pocket to the hem. As he'd walk, or move, or cough, coffee would slosh out, running down his white coat, pant leg, and to the floor. He never seemed to notice.

He was, though,  clearly aware of it, because he'd change into a clean coat as soon as he got to his clinic.

Like in "The Hitchhiker's Guide to the Galaxy," the resident on rounds with him would carry around a large towel (we kept several old ones in the call room for this purpose) to keep the floor from being slippery and wet as Dr. Levodopa wandered to and fro. He was, as best we could tell, completely oblivious to our efforts. Or, more likely, just didn't care.

25 years later... and I still don't understand why he did this.

Monday, July 3, 2017

Not particularly helpful

Seen in a chart. Apparently, death is a diagnosis, and it has a 100% chance of running in families.

Thursday, June 29, 2017

Breaking news

Dr. Grumpy's crack team of reporters, bringing you the stories that shape your world.

Dateline: Shanghai, China. A flight from Shanghai to Guangzhou was delayed for 5 hours when an 80 year-old woman threw a handful of coins into one of the plane's engines. She apparently did this to ensure good luck on the flight.

A team of airplane mechanics had to disassemble and inspect the Airbus's engine to make sure none of the turbines were damaged and to remove all coins.

The total value of the coins involved was roughly 20 U.S. pennies.

Dateline: Tulsa, Oklahoma. A dead body was found inside a Walmart bathroom. It had apparently been there for 3 days.

A security camera recorded the 29-year-old woman entering the bathroom on Friday. At some point over the weekend an employee couldn't get the bathroom door open, and hung up an "Out of Order" sign. A repair crew found the body on Monday.

Police captain Todd Enzbrenner commented "It’s not every day you find this sort of thing in a business."

Dateline: Allyn, Washington. A man found a dead roadkill raccoon on the road, and decided to use it as bait to catch crabs. Like most dead things, it smelled awful, so he tied a rope to it to drag it about 15 feet behind him as he walked home.

Two drivers pulled over and confronted him, believing he was dragging a dead dog down the street. One of them shot the raccoon-dragging guy in the leg and drove away. He is expected to recover (the guy, not the raccoon). Police are searching for suspects.

Sheriff's department Lt. Travis Adams told reporters "I've been doing this for 21-plus years, and I've never quite heard the 'raccoon being dragged down the road' story before, so it's a new one for all of us."

Dateline: Modesto, California. A 45 year man was arrested for starting a fire in a Walgreen's bathroom.

The man told police that he'd had "an accident," and soiled his underwear. He went into the bathroom to take them off and, for unclear reasons, felt the best way to do so was to light them on fire - while still in them.

This got the underwear off, and the man tossed them in the toilet to extinguish the blaze. While no damage was done to the store (or, amazingly, him), this set off the fire alarm and they had to evacuate the building.

Monday, June 26, 2017

Bow wow wow yippie yo yippie yay

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

Mrs. Woof: "I need to get into Dr. Grumpy right away! I was bitten by a dog, and may have suffered nerve damage!"

Mary: "Okay, we don't have anything until next week, are..."

Mrs. Woof: "But this needs to be done urgently. I think I need stitches!"

Mary: "Um, when did this occur?'

Mrs. Woof: "Five, maybe ten minutes ago. It's bleeding all over the place!"

Mary: "You need to go to ER. Dr. Grumpy doesn't handle injuries like this."

Mrs. Woof: "But there might be nerve damage! He's a nerve doctor!"

Mary: "Yes, but he's not going to put stitches in it, or know what else to do. You need to go to ER, and let them see what's going on."

Mrs. Woof: "You people are a waste of time!"


Friday, June 23, 2017

Don't piss him off

Seen in a chart:
"Well, that's not so big, works out to only 563 meters."

Wednesday, June 21, 2017


Mrs. Pesce: "That's not the same fish you had at my last visit, is it? I thought it was a different color."

Dr. Grumpy: "Yeah. It's a new fish. Ed, uh, retired.”

Mrs. Pesce : "So what's this one's name?"

Dr. Grumpy: "Ed. I name them all Ed. Makes life easier."

Mrs. Pesce: "You know, I didn't like the last fish. Every time I came in he looked at me, really angry. Like he thought I was faking everything. I hate to say it, but I'm glad he's dead, because I'd been thinking about changing neurologists because of him and his attitude."

Monday, June 19, 2017

No shit, Sherlock

These are the kinds of warnings that modern, technologically advanced, highly sophisticated computer prescribing systems give us dumb ol' doctors when we're trying to refill your medication. Because even if we're just refilling it, the computer wants us to know that IT'S DANGEROUS TO DO SO because apparently you're already on it (which is the whole point of a refill, isn't it?).

And what's with the weird capital / lower case scheme on some of these?

Wednesday, June 14, 2017

Breaking news

Dr. Grumpy's crack team of reporters continue to bring you the stories that shape your world.

The summer amusement park season is upon us, and unfortunately tragedy has already struck at America's most legendary one.

This past Friday night 17 people, including 6 innocent children, were enjoying an up-till-then fun day at Disneyland. They were standing near Sleeping Beauty's castle when they were horrifically splattered with a large volume of bird poop from a passing flock of geese.

An unidentified bystander, who apparently doesn't know shit, called 911 to report that someone was throwing human turds at people.

This resulted in a city HazMat team being dispatched to the scene, hopefully in those bright yellow suits so people would think they were re-enacting a child alert from Monsters, Inc.

The crappy situation was resolved by taking the victims to a "private restroom" (what does that mean, anyway? No one has used it since Walt died, like the room over the fire station?). There they were provided with clean clothes ("Birds shit on me at Disneyland and all I got was this crappy T-shirt").

At press time the geese were unavailable for comment.

Monday, June 12, 2017


Dr. Grumpy is no stranger to not-particularly-worthwhile research, having published some myself.

I get it. You didn't want to do it, but you're in training, and your chairman made you write up something embarrassingly bad in order to graduate. BTDT.

Last week, some of the biggest names in Parkinson's disease (besides James Parkinson) gathered in Vancouver, BC, for a conference.

One of my colleagues there noticed this poster hanging in the meeting's research hall:

To summarize:

Earthquakes are bad. Having Parkinson's disease, AND being in an earthquake, is worse.

The bigger the earthquake, the greater the effect will be on a Parkinson's patient.

Their symptoms will get worse in the immediate aftermath of the quake, but gradually return to baseline as things settle down.

Thank you, SMOD!

Saturday, May 27, 2017

Holiday road

All right, with the kids' band stuff, school getting out next week, the kids' band stuff, visiting relatives who have given us short notice, all sorts of school-year-end craziness, and the kids' band stuff, I'm going to have to take 2 weeks off from the blog to deal with the insanity.

And I need to pick up beer.

Lots of beer.

See you in 2 weeks!

Friday, May 26, 2017

Friday reruns

One of my all-time favorite chart excerpts:

Wednesday, May 24, 2017


Ms. Auth: "Major Illness Insurance."

Dr. Grumpy: "This is Dr. Grumpy. I'm calling to get a medication authorized on a patient."

Ms. Auth: "Okay, what is their 10 digit ID number"

Dr. Grumpy: "It's... The only number on her card is 7-digits, 8675309."

Ms. Auth: "No, I need the 10 digit one"

Dr. Grumpy: "There isn't another number on here."

Ms. Auth: "Well, I can only work with the 10 digit one."

Dr. Grumpy: "What about her name and birthday? Or Social Security number?"

Ms. Auth: "We don't use those. The only thing I can work with is her 10 digit number."

Dr. Grumpy: "How do I get that?"

Ms. Auth: "Call back and press option 5. Then enter her 10 digit number in order to get it."

Dr. Grumpy: "But I don't have the 10 digit number!"

Ms. Auth: "Then we can't help you, can we? Have a nice day."

Monday, May 22, 2017


Dr. Grumpy: "That's odd for you to have a seizure. Did you miss a medication dose?"

Ms. Rummage: "Yeah... Actually I haven't taken it for almost a week."

Dr. Grumpy: "Did you run out?"

Ms. Rummage: "No, I've just been really stressed out over having a garage sale."

Friday, May 19, 2017

May 20, 1937

80 years ago tomorrow, one of the finest moments in BBC history occurred.

Lt.-Cmdr. Thomas Woodrooffe was a retired Royal Navy office who covered the navy for BBC news. He’d previously served on the battleship HMS Nelson.

In 1937 the fleet held a large review at Spithead, which included the visiting battleship USS New York. The plan was for him to broadcast that evening from aboard HMS Nelson, when all the ships would have lights strung in their rigging.

Unfortunately, after he boarded Nelson he ran into many of his old shipmates, and they decided to have a drink... then another... then a few more... With the end result being that when Woodrooffe took the microphone that night he was completely smashed drunk.

To the horror of his bosses, his live BBC news broadcast consisted of his slurred, inebriated voice, repeatedly saying the fleet was “all lit up, like fairyland” (obviously, the fleet wasn't the only thing lit up) and rambling into the microphone. In that era the technology to cut him off and switch to something else wasn’t readily available, so he was able to go on for several minutes before they finally pulled the plug.

For those who want to listen, this is the actual recording.

If you want to read it, here's a transcript:


This is the Regional Program. The Illumination of the Fleet. Once again, we're taking you on board HMS Nelson for a description of the scene at Spithead tonight by Lieutenant-Commander Thomas Woodrooffe.


"At the present moment, the whole fleet is lit up. When I say 'lit up', I mean lit up by fairy lamps.

"We've forgotten the whole Royal Review... we've forgotten the Royal Review... the whole thing is lit up by fairy lamps. It's fantastic, it isn't the fleet at all. It's just... it's fairyland, the whole fleet is in fairyland.

"Now, if you'll follow me through... if you don't mind... the next few moments... you'll find the fleet doing odd things. At the present moment, the New York, obviously, is lit up ... and when I say the fleet is lit up ... in lamps... I mean, she's outlined. The whole ship's outlined. In little lamps.

"I'm sorry, I was telling some people to shut up talking.

"Umm... what I mean is this. The whole fleet is lit up. In fairy lamps, and... each ship is outlined.

"Now, as far as I can see is about... I suppose I can see down about five or six miles ... ships are all lit up.

"They're outlined, the whole lot. Even destroyers are outlined. In the old days, you know, destroyers used to be outlined by a little kind of pyramid of lights. And nowadays... destroyers are lit up by... they outline themselves.

"In a second or two, we're going to fire rockets, um, we're going to fire all sorts of things, and... you can't possibly see them, but you'll hear them going off, and you may hear my reaction when I see them go off. Because, uh, I'm going to try and tell you what they look like as they go off. But at the moment there's a whole huge fleet here. The thing we saw this afternoon, this colossal fleet, lit up... by lights... and the whole fleet is in fairyland! It isn't true, it isn't here!

"And as I say it ...

"It's gone! It's gone! There's no fleet! It's, uh, it's disappeared! No magician who ever could have waved his wand could have waved it with more acumen than he has now at the present moment. The fleet's gone. It's disappeared.

"I'm trying to give you, ladies and gentlemen... the fleet's gone. It's disappeared. I was talking to you... in the middle of this damn (cough), in the middle of this fleet... and what's happened is the fleet's gone, disappeared and gone. We had a hundred, two hundred warships around us a second ago, and now they've gone, at a signal by the Morse code, at a signal by the fleet flagship which I'm in now, they've gone, they've disappeared.

"There's nothing between us and heaven. There's nothing at all."

Wednesday, May 17, 2017

Wednesday reruns

Last night I was at a dinner meeting for a research company. These things are always held at some swanky overpriced steakhouse.

Dr. Duffel is a local neurologist who drags around the biggest damn purse in the world. It's HUGE, and goes everywhere with her. For years many of us have wondered what's in it: a complete set of every neurology journal ever written? Jimmy Hoffa? an iPhone 87s+?

So last night she came in late to the dinner, and sat down next to me. She put el monstro humungo purse on the floor next to me, so I had to move over a bit.

The meeting dragged on. One slide after another. The occasional cell phone ringing. The speaker droning. Food courses.

At some point I wandered out to stretch and empty myself of biologically-filtered Diet Coke. When I came back and sat down I stepped in a puddle on the floor. I figured someone must have spilled water or something while I was out of the room, and refocused my attention on the speaker.

A minute later a waitress came by to refill my Diet Coke, and stumbled over the giant purse.

And the purse started barking.

The waitress screamed and leaped back, dropping the pitcher on the purse, which only got it snarling at her.

Dr. Duffel jumped up, grabbed her cell phone (which hadn't rung), mumbled "I have to answer this outside" and dragged her growling purse out of the room. I'm pretty sure it wasn't her ringtone.

She never came back.

I rinsed off my shoes when I got home.

Monday, May 15, 2017

Sunday night

It's 11:18 p.m. I'm fast asleep, and my phone rings.

Dr. Grumpy: "Hello?"

Dr. Brain: "Hi, Ibee? It's me."

Dr. Grumpy: "What's up?"

Dr. Brain: "I couldn't sleep, so I'm reading the new issue of 'Journal of Obscure Neurological Diseases of Burkina Faso.' Have you looked at this months?"
Dr. Grumpy: "Uh, it's 11:30 at night and I was..."

Dr. Brain: "They're COMPLETELY changing the diagnostic criteria for Fleaglehart's Syndrome! I disagree with the entire thing. I mean, now they're considering visual changes to be helpful, but not diagnostic, of the disorder. They're increasing the importance of mental status changes, and now there are more than the 2-3 standard MRI findings we're used to."

Dr. Grumpy: "Uh..."

Dr. Brain: "This is RIDICULOUS! I mean, how many cases of Fleaglehart's Syndrome have you seen that would fit this new criteria?"

Dr. Grumpy: "Look. It's 11:30 at night, you woke me up, and honestly I've never seen a case of it."

Dr. Brain. "Really? Neither have I. Okay. Have a good night."

Friday, May 12, 2017

The visitor

I'm in my office looking through MRI reports.

Mary: "Hey doc, there's a drug rep up front, says he needs to talk to you. Says it's not a sales call."

Dr. Grumpy: "Okay, just send him back."

(drug rep comes in)

Dr. Grumpy: "Hi, Matt. What's up?"

Drug rep Matt: "Sorry to bother you, but I was told to come talk to you about a weird request my company got."

Dr. Grumpy: "About..."

Drug rep Matt: "A patient of yours called my company, and said you'd authorize her to get 4 replacement injector pens and we just had to contact your office. I thought I'd come by myself, since we hadn't heard anything about this from you guys."

Dr. Grumpy: "Did you hear what happened to the pens?"

Drug rep Matt: "That's the weird part. She contacted 3 service reps, told one the pens were stolen, another that they were never delivered, and another that her boyfriend backed over them with his car."

Long pause

Dr. Grumpy: "Actually, she and some friends got drunk and then tried using them to pierce their ears."

Long pause 2 

Drug rep Matt: "Are you shittin' me?"

Dr. Grumpy: "Nope."

Drug rep Matt: "I'm going to assume your story is the correct one?"

Dr. Grumpy: "That's the one she called me with Saturday morning."

Drug rep Matt: "I'm pretty sure we don't have a program to replace pens lost through, um, misadventure."

Dr. Grumpy: "Believe me. I understand. We've been dealing with her all week."

Long pause 3.

Drug rep Matt: "Thanks. I'll let you go. Wow. This sounds like something you'd read on a med-blog."

Wednesday, May 10, 2017

Annie's desk

Ms. Myelin: "Hello?"

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

Ms. Myelin: "Oh, good. Did you order my new MS pens?"

Annie: "No, I just got off the phone with your insurance, and they won't replace pens that are damaged that way."

Ms. Myelin: "That's what they told me, too!"

Annie: "You called them yourself?"

Ms. Myelin: "Yes, I figured you'd just ignore me. Do you have any idea how long they made me sit on hold?"

Annie: "Um, yeah."

Ms. Myelin: "This is ridiculous. I need this medication, and my insurance company won't give it to me, even though it's been authorized and I've paid all my premiums."

Annie: "Well, you get a limited number of pens a year, and that's what they've given you. You broke 4 of them using them for something they weren't designed for."

Ms. Myelin: "Like it's my fault they put such a cheapshit needle on that it broke."

 Annie: "I..."

Ms. Myelin: "Can't you tell them that they were defective? Or that I broke them defending myself from a burglar or something?"

Annie: "I need to point out here that you called them before me, and told them the real story."

Ms. Myelin: "I didn't think they'd be such uncaring assholes. Whatever happened to 'honesty is the best policy'? I'm pretty sure the insurance phone bitch was laughing at me."

Annie: "Well, at this point the only way you can get them replaced is to pay cash."

Ms. Myelin: "WHAT? Do you have any idea how much this costs? It's $1200 for each of their crappy pens."

Annie: "There's really nothing else I can do"

Ms. Myelin: "Can Dr. Grumpy pay for them? He's the one who prescribed it, after all. I just took his advice."

Annie: "No. Maybe you should ask Ashley and Amy for help?"

Ms. Myelin: "I'd never ask my friends to do that for me."

Monday, May 8, 2017


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

Ms. Myelin: "Hi, I see you for Multiple Sclerosis, and I'm on that drug you inject with a special pen?"

Dr. Grumpy: "Yes?"

Ms. Myelin: "I need to get 4 new pens ordered for the month. The ones I have are all broken, so I'm going to run out."

Dr. Grumpy: "A month's worth of injector pens were all broken?"

Ms. Myelin: "No. I mean yes. I mean, they are now."

Dr. Grumpy: "Did they get shipped to you broken?"

Ms. Myelin: "I don't think so."

Dr. Grumpy: "So how are they all broken?"

Ms. Myelin: "Well, for Cinco de Mayo me and my girlfriends were at the Smashed Iguana. They were having tequila shot specials, and they do that thing where they pour margaritas right in your mouth? Anyway, we came back to my place to crash, and while we were sitting around Ashley said she'd been meaning to get her ears pierced in new places. Amy volunteered, cause she once did her own when she was in high school and said she'd been meaning to do the same. But I didn't have anything that would really work, then remembered I had my MS drug injector pens and they have pretty sharp needles, so we..."

Dr. Grumpy: "You used MS injector pens to pierce your ears?"

Ms. Myelin: "Well, yes. I mean, on a Friday night at 11:30 it's not like the place at the mall was open."

Dr. Grumpy: "I'll talk to Annie and get back to you on Monday."

Friday, May 5, 2017

Friday reruns

Dr. Grumpy: "So at what point did you call 911?"

Mr. Young: "When I realized she was having a seizure."

Dr. Grumpy: "How long after the seizure started was that?"

Mr. Young: (looks at Mrs. Young, both blush, look at floor) "Well, I didn't call right away, because we were, um, having sex at the time, and when she started shaking I just thought she..."

Dr. Grumpy: "Got it. So how long did the seizure last?"

Wednesday, May 3, 2017


Mary: "Let me give you these forms... Here's a pen... can I get a copy of your insurance card?"

Mrs. Card: "No."

Mary: "Do you have it with you?"

Mrs. Card: "Yes, but I don't know Dr. Grumpy yet. Can I give it to you after the visit, if I think he deserves to get paid?"

Monday, May 1, 2017


Dr. Grumpy: "At your last visit we started Flingase, how's that been going?"

Mrs. Scalp: "It's helped my migraines, but causing a lot of hair loss! I feel like I'm going bald!"

Dr. Grumpy: "Yeah, like we'd talked about, that can be a side effect."

Mrs. Scalp: "The trade-off just isn't worth it. I want to try something else."

Dr. Grumpy: "That's fine. Let me..."

Mrs. Scalp: "Here's this."

(puts a Ziploc bag on my desk)

Dr. Grumpy: "Uh... what's that?"

Mrs. Scalp: "It's all the hair that's fallen out. I've been saving it for today."

Dr. Grumpy: "I, um, see."

Mrs. Scalp: "Since you were familiar with the drug I figured you'd know a way to put it back on. Isn't there a Flingase antidote?"

Dr. Grumpy: "No, but it'll grow back with stopping the drug."

Mrs. Scalp: "Will it all be back by this weekend? I have a wedding to go to."

Dr. Grumpy: "No..."

Mrs. Scalp: "Well, this is a lot of hair." (picks up bag) "Do you have glue or something?"

Friday, April 28, 2017


Seen in a chart:

Wednesday, April 26, 2017


My office parking is okay. Not great, not horrible. Generally anyone can find a space, but they may have to park farther than they like (we do have plenty of handicapped spots).

I have one patient, Mr. Thuesen-Hale, who perennially complains about it. It's almost Seinfeldian, were it not for him being so enraged. Mary even gave him a list of neurologists who might have a better office lot than I do, to no avail.

So at his appointment last week, he showed up with a bunch of papers. They looked like forms for work.

Dr. Grumpy: "Any other questions?"

Mr. Thuesen-Hale: "Yes, I have this for you."

Dr. Grumpy: "Is it for your job?"

Mr. Thuesen-Hale: "No, it's a parking ticket."

Dr. Grumpy: "A parking ticket?"

Mr. Thuesen-Hale: "Yes. Because of your crappy parking here I got a ticket last time for being on the street. So it's your responsibility to pay it." (shoves papers at me)

Dr. Grumpy: (not reaching for them) "I'm sorry you got a ticket, but I'm not going to pay it."

Mr. Thuesen-Hale: "That's unacceptable. You chose to rent in this building, so it's your problem. PAY IT!"

Dr. Grumpy: "I'm not going to do that."

Mr. Thuesen-Hale: "Look, if you don't pay it I'm not coming back!"

It's funny how some people think that's a threat.

Monday, April 24, 2017

Random pictures

Okay, time to hit the mail bag for stuff you guys have sent in:

First we have this doctor's office:

"How's the weather down there?"

From the "but don't do it right now" department of driving safety:

"Gee, this sounds like a great place to live"

"I guess the gardens are by the rear entrance."

From the music store (for those of you who remember what one was).

"Better not look in the other bin" department:

People who can't spell are watching you:

And, lastly, a reminder of those good old days of pharmacy:

Friday, April 21, 2017

Modern medicine

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

Ms. Thirst: "Yes, I need to make an appointment with Dr. Grumpy."

Mary: "Okay, our next available is on Thursday, at..."

Ms. Thirst: "Wait, first of all, do you offer a beverage service in your lobby?"

Mary: "Uh, no. There's a water fountain down the hall, by the... Hello? Hello?"

Wednesday, April 19, 2017

Wednesday reruns

Mrs. Powder: "Sorry I'm a few minutes late, I had to drop my husband off at the ER."

Dr. Grumpy: "Is he okay?"

Mrs. Powder: "Oh he's fine. He was cleaning his gun and shot himself, again."

Dr. Grumpy: "Oh my..."

Mrs. Powder: "You'd think he'd get over being such a baby about it. I made him wait in the car until I'd finished the laundry. Anyway, at the last visit you had me try Nomig for headaches, and I like it. Do you have any more samples?"

Monday, April 17, 2017


Last week I got a letter from an insurance company about a patient's medication. No biggie. Happens a lot.

The letter said my patient's prescription authorization was expiring next month, and that I needed to fill out and resubmit the forms to get it covered for another year. Okay, I do that a lot, too.

But this letter, in the interest of protecting patient privacy, didn't give me their name. Or the medication. Or their diagnosis. Not even an ID number or birthday. Zilch. Zip. Nada.

In fact, across the top of the letter it said:

And I must admit they were right. The only name on the letter was my own.

So what am I supposed to do? I want to help the patient, but a quick look at my computer says I currently have 1,043 active patients. At least 278 of them are on a medication that requires me to re-authorize once a year. I can't start calling all of them, either. Ones who are coming due in the next 2 months? 44 per my machine. That's still too many for a random guess.

No easy answer here.

Sadly, the way these things usually play out is I'll only know who it is because they go for a refill and are told the medication is no longer covered because uncaring Dr. Grumpy never bothered to do the authorization. So they call and yell at me because they're not going to get their medication "AND IT'S ALL YOUR FAULT!" (my kids love that line, too).

I'm a big believer in patient privacy. I work hard to protect it. But when information about a patient, and a potentially life-saving medication for them, is kept secret from the very doctor who's prescribing it... We've reached a new level of insanity.

Franz Kafka (not my patient)

Friday, April 14, 2017


Seen in a chart:

Of course, there's only one medicine that treats it all.

Wednesday, April 12, 2017


One night, just after starting my internship, I got called to pronounce a patient dead.

How hard can that be?

They paged me just after midnight. As I took the elevator to that floor I realized that... I had no idea how to pronounce someone dead.

My medical school had covered all kinds of stuff about diagnosis and treatment of the living, and, in retrospect, zilch about how to tell if someone is dead.

My stomach sank as I realized I'd be learning on the fly. I buttoned my brand-new white coat and made sure I had my stethoscope.

I got to the room. Mercifully, the family had gone home for the night and there were just 2 nurses straightening things up.

The ex-patient's eyes were wide open. He stared straight ahead, pining for the fjords.

Trying to look like I knew what I was doing, I strode confidently over to the bed... then stopped as I realized I had no idea where to start.

Finally, I waved my hand in front of his eyes.

He didn't blink.

The nurses began laughing. I began sweating.

Realizing I was hopelessly lost, and blanking, one took pity on me and suggested checking his pulse and perhaps use my stethoscope. At that point I began remembering things like vital signs (or the absence thereof) and other basic proof/disproof of life.

"He's dead, um, what's your name?"

I lay in my call room the rest of the night, waiting for a page from the morgue that the guy had woken up and was wondering what kind of idiot had pronounced him dead.

Monday, April 10, 2017

Sunday morning, 12:37 a.m.

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

Mr. Phone: "Yeah, I see Dr. Nerve for my headaches, and when I had one last month he called in some Migroblast, and it was really effective. Do you know if he'll call it in next time I have a headache?"

Dr. Grumpy: "Are you having a headache, sir?"

Mr. Phone: "No, I'm fine, I haven't had one since then. I only get a few each year. But if I have one, will he call in the Migroblast again?"

Dr. Grumpy: "Why don't you call his office on Monday and ask?"

Mr. Phone: "Oh, I guess I can do that. Hey, have a good night!"

Friday, April 7, 2017


Mrs. Worry: "I'm concerned about Alzheimer's Disease, because I have a family history of it."

Dr. Grumpy: "Who had it?"

Mrs. Worry: "My ex-husband."

Wednesday, April 5, 2017

Mary's desk

Mr. Stand: "Hello?"

Mary: "Hi, this is Mary at..."

Mr. Stand: "Um, are you the girl I met last Saturday at Pick-Up Charlie's? Hey, the reason I haven't called yet is because..."

Mary: "Uh, no, I work at Dr. Grumpy's."

Mr. Stand: "I don't remember a bar called Dr. Grumpy's. Where is it? I must have been blitzed. Anyway, I'm glad you called because..."

Mary: "Dr. Grumpy is a neurologist. You have an appointment here at 10:00 tomorrow morning. I'm calling to remind you of that."

Mr. Stand: "Wait, you work at my neurologist's AND you came home with me from Pick-Up Charlie's last weekend?"

Mary: "No. I work here. I'm married. I've never been to Pick-Up Charlie's."

Mr. Stand: "Oh... This is awkward... I guess I'll see you tomorrow at 10:00, then."

Monday, April 3, 2017

100 years to the day

This picture was taken 100 years ago today, off New York City. It's the U.S.S. Arizona, shortly after completing engine repairs and only 6 months after she was commissioned into the navy. 3 days after this picture was taken the United States entered World War I.

At the time she was the biggest, newest, and most advanced battleship in the world. And home to 2,290 young men.

This is the same ship today, after the beginning of another war. 1,177 young men are still aboard her.

Friday, March 31, 2017

Check, please

This weekend Craig is hosting a murder-mystery party for his friends, with crimes he's writing himself.

Last night we stopped for a bite on the way home from band practice. He had a notebook, and was frantically writing down ideas for the party mysteries.

At one point he said "One more to go. I JUST NEED INSPIRATION FOR ONE MORE MURDER!!!"

Saying that loudly gets you some interesting looks in a crowded diner.

Wednesday, March 29, 2017


Dear Cureus,

Thank you for your recent email.

I must say, I'm delighted that you enjoyed my article "," which was published in , . I spent years working on it, as a much-anticipated follow-up study to "?" and ".", which you may have seen in / and ;, respectively.

I'm impressed that your "new and unique" article rating system felt "," was so important. I'd been concerned, as several colleagues were less flattering, comparing it to something one might see produced by a :

Please keep an eye out for my "!" which will be featured in next month's issue of " as the centerfold.

Yours truly,

Ibee Grumpy, M.D.

- Thank you, SMOD!

Monday, March 27, 2017


Mrs. Gourami: "What's your fish's name?"

Dr. Grumpy: "Ed."

Mrs. Gourami: "And he just stays over there?"

Dr. Grumpy: "Yep."

Mrs. Gourami: "That really bothers me. I mean, for him to be in there all the time. You'd think he'd want you to take him out of the water for a walk or something."

Dr. Grumpy: "Uh..."

Mrs. Gourami: "It just doesn't seem fair to me, like animal cruelty."

Sunday, March 19, 2017

On the road again

Taking a week off for the kids Spring Break. See you next week!

Friday, March 17, 2017

"Don't eat or drink out of it, either."

Seen in a hospital bathroom:

Thank you, Rachel!

Wednesday, March 15, 2017


Last night was the twins' indoor marching band show, combined with a school dance recital.

We took my Grumpymobile (a used 2007 Toyota Highlander, recently bought to replace the 1999 Nissan Maxima which had died). Frank also went, since he does lighting for the auditorium.

After the show there were 3 girls and 2 boys chatting with the twins. I let them talk for a few minutes, but after a while I wanted to go home, and went over to break it up.

Apparently, they’d been waiting on ME. Without bothering to check with, say, ME OR MRS. GRUMPY, Craig had previously promised these kids rides home. Since their parents had been told they didn’t need to come get them, they’d made other plans. And it was too late, dark, and cold to walk.

So we were 10 people in a car that holds 5, max.

It ended up as 3 in front (one on my wife's lap), 4 crammed in the back seat, and 3 shoved in the hatchback cargo area in back. It was snowing. The windows were fogged from 10 sets of respirations. Off we went, with my phone giving us directions to their homes.

Marie is taking driving lessons, and has memorized the entire book of state driving laws. So she points out any traffic violations she sees, loudly.

When someone made a turn in front of us without using their signal, she rolled down her window (with snow coming in) and shouted “HEY! That’s against the law!”

Craig's yelled from the cargo area: “So is driving around with 3 kids in your trunk!”

Then Frank farted, LOUDLY, and the whole car smelled like a sewer. On top of the body odor of a bunch of teenagers who have just finished marching and dancing for 2 hours under hot stage lights.

I drove the rest of the way with the windows down, and didn’t care if they froze.

At least I know these kids will never ask for a ride with the Grumpys again.

Monday, March 13, 2017

Guessing games

This referral came over the fax machine last week:

Thursday, March 9, 2017

Mary's desk

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

Mrs. Osseous: "I have a skin tag on my forehead, and need to have it removed."

Mary: "I'm sorry, Dr. Grumpy doesn't do that sort of thing."

Mrs. Osseous: "But it's on my forehead? That's near my brain, isn't it? And he's a brain doctor!"

Mary: "Yes, but he doesn't do procedures like this. Why don't you ask your internist for..."

Mrs. Osseous: "I did. She told me to see a plastic surgeon, but when I called none of them take insurance, and only wanted to talk about fixing my boobs."

Mary: "Have you tried a dermatologist?"

Mrs. Osseous: "They're booked out for a month, and I'm tired of looking at this thing in the mirror after 10 years. I want it off NOW! Can you ask Dr. Grumpy to make an exception?"

Mary: "This just isn't what he does, or can help you with."

Mrs. Osseous: "Even if it's near my brain, just on the other side of my skull?"

Mary: "That's not his field."

Mrs. Osseous: "You people are worthless."

Monday, March 6, 2017


My reader Tom writes that a friend of his recently had a vasectomy at a place called, I swear, Dr. Snip.

What really makes the whole thing noteworthy, beside a few bags of frozen peas, is the awesome parting gift they present you with after the procedure:

Now THAT's branding!


Thank you, Tom!

Friday, March 3, 2017

Seen in a chart

Wednesday, March 1, 2017

My readers write

From Dr. Max Alt...

In the late 1990's I worked for Ginormous Neurology, Inc.

GNI was a group of 30-40 neurologists carefully selected for significant personality pathology. In neurology this isn't hard to find* but the breadth and scale of it at GNI was truly awe-inspiring. I don't think I was as bad as most of them, but hey, they offered me a job and I needed one.


GNI spent a large amount of money to put together a computerized chart system. By the standards of the era it was reasonably good, and fairly quick. Come to think of it, it was better than most of the  crap out there today.

One Monday the system was really SLOW. Granted, these sorts of things happen, and so we all ignored it at first. But it continued the rest of the day, and the next, and the next... The IT guys found something was running in the background, but weren't sure what it was.

Checking the logs on the servers and individual machines, they eventually discovered that one of the partners, Dr. Kent, had spent several hours over the weekend logged into the system, working on most of the office desktops, one at a time.

Eventually it came out that Dr. Kent had secretly installed software on all the computers... to search for extra-terrestrial life.

"He did WHAT?"

I am not making this up. He'd quietly installed programming from SETI (Search for Extra-Terrestrial Intelligence) to allow them to use the GNI network to search through data picked up by radio telescopes in hopes of locating life out there.

Now, I have nothing against SETI. Or extra-terrestrials. Or science. But when they interfere with my ability to do my day job... that's another matter.

To Dr. Kent's indignation and horror (he thought this would get him a Nobel Prize) the IT guys spent the next weekend removing his software from the servers and roughly 150 computers scattered through the GNI network.

To this day, those of us who knew Dr. Kent think he was hoping to reconnect with his family.

Thank you, Dr. Max Alt!

*I'll vouch for him on that - Dr. Grumpy.

Friday, February 24, 2017

Breaking news

From around the world, Dr. Grumpy brings you the stories that impact your lives.

DATELINE: New Brunswick.

Two men were arrested for going through a McDonald's drive-thru on a moving sofa at 3:19 a.m.

The home furnishing, also called a couch, was being towed by a 3rd man riding an ATV, also called a deathtrap. The passengers went over to order some McEdibles.

Apparently going into a drive-thru on a towed couch is illegal there (I had no idea this was such a common crime that a specific law was needed) so a police officer pulled in behind them and turned on his lights. This resulted in the ATV guy and couch driving off (down a frozen river, no less) leaving his partners behind.

The two men, not surprisingly, were intoxicated.

Cpl. Lorri McEachern, of the New Brunswick police, commented that, in spite of riding drunk on a towed sofa in winter in the middle on the night, both men were wearing helmets "so obviously safety was somewhat important."

DATELINE: Arizona AND Florida

Robert Bare, tired of life in Bullhead City, Arizona, decided to take a vacation in Key West, Florida. As part of his relaxation he wanted to "party" (his word, not mine) and mailed a box of crystal meth from his home to the hotel he'd booked.

Regrettably, Mr. Bare forgot to address the box to himself, simply writing the name of the hotel on it. So the staff opened it and were surprised to find some Walter White confectionary wrapped in dirty socks. Mr. Bare had, however, been kind enough to put his name and home as the return address on the package.

Following his arrival, Mr. Bare was arrested by an undercover detective when he tried to reclaim his package "after a brief struggle in the lobby."

DATELINE: California

A fellow stole a van from a mortuary in Riverside. After a short distance, however, he discovered there was a dead body in the back.

Apparently not wanting the passenger, he drove back to the mortuary, politely parked the van and its occupant where he'd found them, THEN took another van next to it (I assume he checked the back first), nearly running over a mortuary employee in the process.

While stealing van #2 he somehow failed to notice a police officer standing there, investigating the theft of the first van. The intrepid officer apprehended him after a chase.

DATELINE: Mississippi

From the "somehow I think there's more to this story" department.

Shane Treadaway was found hanging upside down and buck naked from a tree in the forest.

Mr. Treadaway, who was rescued by the local fire department, said he'd climbed the tree to look for a dog, and fell. Apparently all of his clothes came off in the process.

His girlfriend, who happened to be at the scene, ran to a nearby house to get help.

Wednesday, February 22, 2017

Attention span

I do online marketing surveys for $ here and there. Most docs do.

These people obviously want to make sure you're paying attention, so have stealth questions in there to trip-up someone who's randomly clicking boxes or typing numbers. Here are some samples you guys have sent in:

Sometimes it's just a simple command:

Math questions are popular, I assume because you have to think a bit:

Another technique is what I call "left turn." They set the premise you're going to work on, then take a sudden left turn off subject to see if you're following them:

But THIS one is my favorite. A seeming innocuous question about drugs used for Parkinson's Disease:

For those of you who didn't follow the sci-fi show Firefly, Byphodine was a fictional drug that reduced metabolic function to fake death.

Monday, February 20, 2017


One of the other residents I trained with (a long time ago, in a hospital far, far, away) was Dr. Tree. He was argumentative and irritating (in short, a pretty typical neurologist). He didn't usually speak to the rest of us, which was a good thing.

Anyway, one day a few of us (both boys and girls) were hanging around in the neurology residents office, bullshitting about random stuff while we waited for rounds to start. Dr. Tree was at his desk, reading some neuro textbook and ignoring us.

At some point we began joking about porn. I have no idea what led to that. This went on for a few minutes, when suddenly Dr. Tree slammed his book closed, came over, and yelled the following diatribe at us:

"You think it's funny! It's NOT funny! The problem with porn is that it gets so out of control! You start with a dirty magazine, then you move into books and movies. You keep needing more and more, and the tame stuff isn't good enough anymore, so you need filthier and filthier, harder-core stuff! It's like a snowball rolling downhill, and YOU CAN'T DO A FUCKING THING TO STOP IT!"

Dr. Tree abruptly stopped and turned red. The rest of us, somewhat taken aback and unsure what to say, looked at him silently.

After a pause he mumbled "Um, at least that's what I've heard."

He picked up his book and ran out of the room.

Wednesday, February 15, 2017

Lost and found

Have you ever wondered what kind of things people leave at the Grumpy/Pissy Medical Emporium? Neither have I.

But a recent post about Mrs. Foote losing her shoe heel inspired me to dig through the office's "lost and found" drawer. It needed to be cleaned out, anyway.

Besides an unclaimed pair of sunglasses and a make-up case, I found these abandoned items:

This absolutely fascinating button: 

Yet another shoe heel:
Apparently, no one came back for this one.

A pocket knife:

Cigarette lighter:


I have no idea what this is:

For that matter, I don't know what this is, either:

Electrical tape:

And, somewhat ironically, this was in the drawer, too.

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