During the seventh hour of internal medicine rounds one day, Dr. Frownalot had an intriguing idea. After hearing the resident present a patient with hypertension mentioned as the first problem, “Lymes” as the sixth, and an ejection fraction of 5% as the eleventh and presumably least significant, the futility of rounds finally dawned on him.

“In the past, when people didn’t know what to do, they just slaughtered animals and hoped for the best. I felt like I could relate,” he was quoted as saying.

He had 25 goats brought into the hospital, and sent to live in the residents’ room. Every morning, instead of rounding on the patients, each goat would be cleaned with chlorhexidine in the most meticulous sterile technique possible, and then it was introduced to the team.

“This is a 16 month old male, with a past medical history of Groat’s Disease,” the intern would announce. The chief resident would then spend 15 minutes attempting to place an IV into the goat, so that they could be sure that its electrolytes were replenished.

After this had been done, the team would proceed to discuss the evidence regarding the mortality benefit of goat magnesium replenishment. Without fail, the goat would then die of boredom within the hour.

“You know, when they first had this idea, I thought it was crazy, and flew in the face of everything we learned in Introduction to Clinical Medicine!” said an eager third year med student. “But the patients actually haven’t been doing any worse. Who would’ve thought?”

GomerBlog’s crack investigative reporting staff reached out to one of the goats for comment. Miraculously, the goat was able to speak fluent English:

“You know, I used to think that just eating grass and pooping all day was kind of boring, but compared to what these schmucks have to go through every morning, it’s like riding a rollercoaster! And I’m a goat, for crying out loud!”

“It’s 2 o’clock. Can we check-in with everyone now?”

The Case Manager huddles with the Charge Nurse as he calls for the nurses. While studies have shown that the addition of afternoon rounding to the already established morning rounds not only improves patient outcomes, communication, and decreases length of stay, the real issue at hand is the need for a daily afternoon staff roll call.

With the recent move to a new bigger acute care facility, unforeseen staffing challenges have arisen giving way to unprecedented nursing folklore riddled with cautionary tales of nursing-staff-gone-by.

There’s the legend of the mole nurses, an entire underground community of those who got lost in the underground tunnels during the move. Echoes of their rubber soled shoes are all that has been heard from them since.

Or the new orientees who rode the elevator to the roof take in the view. Discovering no return access to the tower below, they’ve since set up a tent city on the rooftop helipad.

Don’t forget about the “Stepford Nurses” assigned to the rarely used extra wing, reprogramed through hours of educational videos through the Be Healthy Program.

“Where are they?”

“They’ll be here,” the Charge Nurse reassures, dabbing his brow with his handkerchief, the sounds of a purring motor and a sudden beeping could be heard approaching in the distance.

The nurse saunters off her jazzy scooter, company issued to assist in covering the mile-long floor, just as alarms begin to ring and firewalls lower. The overhead speaker warns, ““Code Ceil Blue, Penthouse! Code Ceil Blue, Penthouse!” She saunters back to her scooter. “Expectations… need to be… lowered,” she remarks through pursed lips as she peels off down the hall and joins the other staff screeching down the hallway after a nurse on foot.

With some quick maneuvering the closest nurses dismount and bring the fleeing nurse to the ground just as the elevator door opens. She digs her nails into the red carpet, kicking and screaming, “I was just trying to find a staff bathroom to privately poop in!”

“Perhaps a recommendation should be for hourly rounding to be done on the staff,” a nurse suggested, dragging the potential escapee back to the station.

After a quick headcount, it was noted that all remaining staff was present and accounted for.

NEW YORK, NY – “Will my patient need placement?” intern Jamie Dreessen asked the Magic 8-Ball, shaking it solidly for 15-seconds before placing it on the conference room table for all the members of her team to see.

IT IS DECIDEDLY SO, the Magic 8-Ball shot back.

“There you have it, 8 has spoken,” responded Lena Stankovich, the attending for the internal medicine teaching team.  “Consult social work.”

Stankovich and her team have dealt with wavering recommendations from numerous subspecialties so far this summer, likely a consequence of new interns, residents, fellows, and attendings having started the newest phase of their medical careers on July 1.  Stankovich felt it would be best to save themselves the time and energy, and consult something equally effective.

Behold the Magic 8-Ball.  Or 8, as the team calls it.

“Look, we realize 8 was marketed as a toy, for entertainment,” remarked Dreessen’s co-intern Timothy McDonough, momentarily sad because the Magic 8-Ball thinks it is VERY DOUBTFUL he’ll go to the bathroom today.  “But I gotta tell you: 8 hasn’t steered us wrong yet.”

Here are some of the questions and answers that took place during this morning’s productive morning rounds:

• “Is this patient a drug seeker?” – WITHOUT A DOUBT
• “How about this other one with the morphine allergy?” – IT IS CERTAIN
• “Will I get a late admission?” – BETTER NOT TELL YOU NOW
• “Is this patient having real seizures?” – MY REPLY IS NO
• “Will radiology get the CT done today?” – MY SOURCES SAY NO
• “PE and GI bleed: rock and a hard place?” – AS I SEE IT, YES
• “Graham cracker for lunch again today?” – YOU MAY RELY ON IT
• “How is my future as a physician?” – OUTLOOK NOT SO GOOD
• “Was it a mistake working in health care?” – MOST LIKELY
• “Any chance I’ll pay off my student loans before I die?” – DON’T COUNT ON IT
• “Will I catch C. diff one day?” – SIGNS POINT TO YES
• “Who can suck it?” – DR. OZ, DR. MIKE, JOINT COMMISSION, TAKE YOUR PICK

Sources close to Gomerblog believe that if the advice streak remains accurate for the upcoming month, the ACGME will consider replacing interns and residents with Magic 8-Balls.

Local general surgeon, Arthur Wellesley, reclined in his leather armchair yearning for the days of General Surgery domination of nearly every aspect of Surgery.  “Back in the day, our forefathers controlled everything.  We did the amputations, C-sections, mole removals, heart surgery, all of it.  But look at us now, we excise accessory organs, patch hernias, and deal with various afflictions of the buttocks.  It’s sad.”

Once the Lords of the Hospital, general surgeons no longer hold the prestige of being the universal operators they once were.  Gone are the reserved parking spaces, the dedicated OR days and most importantly, the monogrammed thrones in the front row of medical staff meetings.

“It’s sad really, they used to fix bones.  They used to love bones.  Now I am the lover of bones,” explained local orthopaedic surgeon Chester Flexington.  “I honestly couldn’t name an organ they operate on.  To be fair, I can’t name that many organs beside the Ancef pump and the bone aerators.”

Around the turn of the 20th century, General Surgeons operated from toes to the top of the skull, much the way the British empire once covered the entire globe.  Now both are back to their small little island of respite and even that island is getting pecked at by the likes of Family Practice, Interventional Radiology, and Scotland.

“They’re taking everything!  GI and FP doing colonoscopies and flex sigs, IR doing abscess drainage.  Abscess drainage!  We hate pus and they’ve even taken that away from us!” vented a visible exasperated Wellesley.  “We might as well be Internal Medicine with a minor OR once a month.  All we have left is appendices, gallbladders, lipomas, and hernias and the first three of those probably don’t even need surgery, but it’s all we have left!”

Another local orthopaedic surgeon overhearing this rant cast an apprehensive eye at a nearby podiatrist then threatened to take his lunch money if he ever booked a surgery above the talus.

LOS ANGELES, CA – Gomerblog has been alerted by several concerned nurses and medicine residents to the appearance of an ancient bent-out-of-shape internal medicine attending who can best be described as “old as f**k.”  By our estimations here, he is roughly 15 years older than the age at which he should have died.

We have not learned of his actual identity just yet, as we’re afraid the act of conversation might be enough to send Dr. Geri McFartson six feet underground.  The artificial hospital lighting accentuates his fossilized skin.  His gait is exhausted and gives off the impression that he will perish during morning rounds.  The stethoscope around his neck seems almost too much to bear for this grizzled geezer.  One worries that at any moment his head will fall off or his spine will snap in two.

Time stands still as he sits down at the conference table, which may as well be his coffin.  Many wonder if he’ll ever get up again, or what his epitaph will say.

Everyone on the floor pauses and stares at the broken down, debilitated doctor.  Is he awake?  Is he sleeping?  Is he dead?  Is he a ghost?  How f**king old is this dude?!  No one knows.

Even the chaplain passing by says a quick prayer for the soon-to-be deceased.

The team of internal medicine interns and students who alerted Gomerblog to this relic of the past hope that Old F**ker, M.D. isn’t their new attending; they’ve never had to resuscitate a supervising physician before or place one in hospice.  They’re hoping he’s just another demented nursing home resident who managed to steal someone’s white coat.

And hopefully he’s DNR too.  He better be.  By George, he better be.  He’s f**king old.

LOS ANGELES, CA – Earlier this morning vascular surgeon Dr. Emma Wexler gave Grand Rounds to her fellow colleagues at Cedars-Sinai Medical Center.  Unfortunately for her and everyone in attendance, her Grand Rounds weren’t particularly grand.  In fact, call it for what it was: a total abomination.

“Oh yeah, I struck out big time, big time,” Wexler acquiesced, stating that she was even close to falling asleep and she was the one giving the talk.  She made several poor decisions, such as using small-fonted text, reading off of all the PowerPoint slides, and failing to include any pictures or images of cute children or small furry animals.  “Grand Rounds should be just that: GRAND.  Mine?  PITIFUL.”

Thankfully, by a miracle of God or some other divine intervention, the Grand Rounds wrapped up a few minutes earlier than expected, saving those unconscious in the crowd from intubation for airway protection.

Shortly after the presentation, Wexler went through the surveys filled by her colleagues that weren’t crumbled up and aimed at her head in disappointment.  95% of those surveyed described her performance negatively.  Comments included: “Yawnfest 2017,” “Grand Rounds?  More like Bland Rounds,” “Wait for it… And I’m in asystole,” and “This is worse than a talk by a med student.”  The other 5% of the surveys had no comments, but only bloodstains at the edges which were most likely an attempt by people to slit their own wrists.

“These rounds are supposed to be grand, magnificent!” pleaded neurologist Tomas Garcia.  “The field was Vascular Surgery today.  I was hoping for exploding AAAs, maybe even some brachial arteries on fire!  But no.  None of that.  What did we get instead?  A talk on ankle-brachial index.  F**k my life.”

Health care professionals are demoralized but hope for better luck with next week’s Grand Rounds to be given by esteemed orthopedic surgeon Brock Hammersley.  His topic is “Are Boners Bones?  A Review of the Evidence.”

WASHINGTON, DC – Late last night a very visibly tired Surgeon General of the United States Vivek Murthy finally finished rounding on every American in the United States, a patient list of about 320 million patients, and admitted to Gomerblog that he is absolutely dreading having to write all those notes.

“Back when I was a hospitalist, I thought seeing 20 patients in a day was tough,” said Murthy, as he lounges back on his work chair, feet up on the desk.  He’s rubbing his eyes as a pot of coffee brews.  “But seeing 320 million patients in a day?  Man, that’s a lot of patient encounters.”  He lets out a prolonged, painful sigh.  “I haven’t eaten, I haven’t peed.  And I haven’t eaten written… a… single… note.”

As the leading spokesperson for the public health, the Surgeon General carries a lot of responsibilities.  One of those responsibilities is addressing the public’s health by talking to and examining every single one of the Americans that make up the public.  That’s a lot of bedside visits.  And a lot of notes.

“Just because I’m the Surgeon General doesn’t mean I get an easy pass on documentation,” Murthy moaned.  “I gotta document and chart just like everyone else.  I hate it.”

Surgeon General Murthy can sympathize with health care providers because he has to answer to someone more powerful than the President of the United States: the Hospital Administrator General of the United States Chaz Moneybags.

“For every nurse, doctor, physician assistant, whomever in healthcare, there needs to be one administrator, so that’s why I exist, to keep this Murthy guy in check,” Moneybags explained.  “I wish he’d stop whining.  What, 320 million notes?  I could do that in like 5 minutes.”

To make matters worse for Murthy, Hospital Administrator Moneybags has declined requests to give Murthy access to an electronic record, so that means one thing: 320 million handwritten notes.

“Looks like I gotta pull out the old ortho trick: write notes without words,” explained Murthy.  “I learned that from the Orthopod General.”