Great attending quotes from training

"If a patient demands to have daily office appointments with you, let them. They're the ones paying for it, and you have to be there anyway. They'll get bored and stop after 1-2 weeks. This is a war of attrition, and you'll always win."

Free

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

Mr. Gratis: "Hi, I need to see the doctor."

Mary: "Okay... We have an opening tomorrow at 2:30. What insurance do you have?"

Mr. Gratis: "I don't have insurance."

Mary: "All right, our cash prices are..."

Mr. Gratis: "Oh, there's no charge for the visit. I was referred by Boondock Hospital."

Mary: "What?"

Mr. Gratis: "I was seen in the ER at Boondock Hospital last week, and they told me I should see a neurologist. Your name was on the list they gave me."

Mary: "Yes, but we still charge for the visit."

Mr. Gratis: "It's supposed to be free. A hospital referred me!"

Mary: "I understand that, but it doesn't mean we don't bill for our services."

Mr. Gratis: "I can give you the name of the doctor there. Can you bill her? Or the hospital?"

Wonder powers activate!

Medikidz is a company that sells medical comic books for kids.

I get it. I was a kid once, and loved comic books. In fact, I think there were educational ones at my pediatrician's cave office then, so I'm glad they're still using them today. (I just wish there'd been a good one for biochemistry during med school).

These are the Medikidz superheroes:

I haven't read the comics, but it looks like they fly around on a giant red corpuscle. Being a neurologist I kind of like the knobby-kneed brain in the background. I'm not sure what to make of the guy in front, as generally I prefer my superheroes to wear pants. There's also the guy behind him on the left, who's carrying eating utensils in his belt. This is not standard JLA equipment.

Anyway, the reason I'm even on this subject is that recently the annual Neurology meetings were held in Philadelphia, and my top field agent, SMOD, was there.

Like many companies, Medikidz had a booth on the exhibit floor. I've seen my share of these. Pleasant sales reps in professional attire extolling the virtues of whatever they're selling.

But not Medikidz. To SMOD's horror, their reps were wearing the superhero outfits:

"For this I got a college degree."

They look kind of lonely. It's good to have a job, but still pretty humiliating to have to be at an adult medical convention wearing spandex and a cape. Normally you only see this kind of outfit on Halloween, when shopping at Walmart, or in the personals section of Craigslist.

Dear Medikidz: if you want to attract neurologists, you should wear Star Trek costumes.

Relevance

On the fax machine yesterday morning was a note from Dr. Intern's office, about a lady who has an appointment tomorrow.

It said: "Please evaluate Flora Betapir for Alzheimer's disease. Records attached."

The attached records were:

Right hand x-rays from 1999

A mammogram report from 2002

and a Pap smear report from 2005

Sigh.

True colors

Last week, for those of you who missed it, Los Angeles Clippers owner Donald Sterling temporarily became the most hated man in America. This is actually pretty impressive, as it involves leapfrogging over politicians, television pundits, lawyers, doctors, and the barista who can never get your order right.

Mr. Sterling's downfall came because of overtly racist statements. This rapidly brought him condemnation from politicians, celebrities, and pretty much anyone with a microphone or Twitter account. People lined up around the block to announce they would boycott Clippers games if he wasn't removed, and team sponsors jumped ship fast.

So, guess who can't boycott Mr. Sterling? I can't. Or anyone in the healthcare field.

Sure, I can refuse to go to his games, or live in one of his buildings. But if he shows up in my office or hospital, I wouldn't turn him away. And neither should any doctor or nurse.

This is one of the hardest things in medicine. Regardless of how we may feel about a person, or disagree with their beliefs, we still have to do our best to help them when they need us. I've taken care of neo-nazi white supremacists, militant black supremacists, dirtballs who shoot police or kill innocent people just because they don't like them... the list goes on. Sterling's condescending boardroom racism is minor league compared to these guys.

It's part of the job. Whether they come to you in the office, or you're seeing them in the hospital, you have to set aside your personal feelings and do your best to help. Dr. Samuel Mudd spent 4 years in prison for providing medical care to John Wilkes Booth - a conviction yet to be overturned.

I never discuss politics with patients, as it's bad for the relationship. But that doesn't stop some from bringing it up, sometimes expressing blatantly racist or antisemitic views. I've had people tell me all blacks should be shipped to Africa, or Jews or homosexuals killed. Do I agree with this? Hell no. But I also believe that part of being a doctor is caring for anyone who seeks my help, regardless of personal feelings for them.

In hospitals they have it even worse. Nurses and doctors there have to deal with people who are drunk, high, verbally abusive, and sometimes violent. And, again, they do their best to help those no one would want to. As professionally as possible.

Like most people these days I don't support or like Mr. Sterling. But that wouldn't stop me, or any number of doctors, nurses, or paramedics from doing our best to help him if he needed us. Because that's what we do.

Overheard in ER

Dr. Urgent: "What brings you to ER today?"

Mr. Couth: "I got a big, huge, ball of shit in my ass and it fucking hurts."


Attention medical students: we at Dr. Grumpy, Inc., will not be held responsible for your grades if you use the above quote when presenting a case to your attending.

Wednesday afternoon

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

Dr. Equine: "Hi, thanks for calling me back. I'm a horse veterinarian at Grumpyville Racetrack. Do you have a patient named Mr. Adipose?"

Dr. Grumpy: "Uh, yeah... I just saw him this morning."

Dr. Equine: "You ordered an MRI on him?"

Dr. Grumpy: "Um... What does this have to do with the racetrack?"

Dr. Equine: "I'm going to guess he's a large fellow."

Dr. Grumpy: "Why..."

Dr. Equine: "He just called my office to see if we had an MRI for horses he could use."