Language

While on call this past weekend I discovered this line in another neurologist's note:

"An ictal event is possible, and cannot entirely be excluded, however our data to implicate such process definitively is somewhat tenuous at this point in time."

Care

Dr. Concerned Internist: "Hello?"

Dr. Grumpy: "Hey, Susan. It's Grumpy. I need to talk to you about Mrs. Aspirin."

Dr. Concerned Internist: "What's up?"

Dr. Grumpy: "Well, you referred her to me for a TIA, so I ordered a carotid ultrasound. Her arteries look okay, but on one side she's got a small thyroid nodule, and the radiologist is worried it's malignant."

Dr. Concerned Internist: "So why are you calling me?"

Dr. Grumpy: "Well, it needs further work-up, and you're her internist."

Dr. Concerned Internist: "You ordered the test that found it, so it's your problem now."

Click

Artisanal mailbag time

First up, from the land down under, (proving the insanity isn't confined to one hemisphere or continent) we have this company:





I can only assume that artisanal air is composed from handcrafted Australian atoms of hydrogen, oxygen, and nitrogen, rather than, say, made 13.7 billion years ago during the big bang.




Next is this, which came up as the error message when the page crashed. So the IT guys are now officially artisans.







Now we have this picture from Las Vegas, advertising a local strip bar.





I suppose in some way the strippers are artisanal, as their chests were handcrafted by some of the finest plastic surgeons in Tijuana.

By the way, your cab driver is asleep.



And lastly, we have this, from CakeWrecks. While not claimed as artisanal, it deserves to be shown. Because, as a neurologist, some things just call for a nice piece of cake.





And that isn't one of them.

Memories

Recently my colleague Sufu, who's in medical school, emailed me about the issues with learning to hear heart sounds.

It brought back memories of a lecture I had back in medical school, when a cardiology professor delivered these helpful quotes:

"This type of murmur sounds like a snowflake landing on a feather."

"You can practice mimicking heart sounds by tapping on Kleenex."

"If you think you heard this murmur, you didn't."

"I've never heard that heart sound, so I don't believe it really exists."

"If you can imagine the sound dandelions make as you blow seeds off them, you should be able to hear this murmur."

Looks like you're on the couch tonight

Mr. Lumbar: "When the leg pain gets really bad it makes driving unsafe."

Dr. Grumpy: "Why? Does the leg get weak?"

Mr. Lumbar: "No, because then my wife has to take the wheel, and she's dangerous."

Law and Order

Today's legal tip:

1. In a criminal case, you should have an attorney represent you, and not do it yourself.

2. If you do it yourself, and lose, you should not try to appeal on the grounds that you were incompetent at doing so.

Thank you, Officer Cynical!

Mary's desk, February 29, 2012

Mr. Irritant: "Hello?"

Mary: "Hi, this is Mary, calling from Dr. Grumpy's office. Your MRI is back, and so I'm calling to schedule your EMG."

Mr. Irritant: "Did he tell you that? Or are you just wanting him to do the test?"

Mary: "He told me to schedule it, sir. He says that the MRI didn't show a cause for your arm symptoms, so he needs to do an EMG to see if there's any damage in the arm itself."

Mr. Irritant: "Can he get on the phone himself and tell me this? I don't trust you desk people."

Mary: "I can have him call you later, but he's with a patient right now."

Mr. Irritant: "I want to hear it from him. I know you desk people work on commission based on tests you schedule."