Saturday 28 January 2012


Some people are misinformed. Some people have no common sense. And some people are just so incredibly clueless that I wonder how they managed to survive into adulthood.

The last patient I admitted last night was a 27-year old woman who was hit by a car. She suffered multiple fractures in her leg, arm, and back. In the heat of the moment, sometimes patients aren't fully informed about the extent of their injuries, so I make it a point to talk to them the next day and make sure they are aware of their situation. So I went to see her this evening, and I told her she had fractures of her back, her tibia, her humerus, and her femur.

"My femur??" she asked wide-eyed. "Am I going to be able to have kids?"

I stared at her blankly for a second while I gathered the strength not to ask her what the FUCK she was talking about.

"Yes ma'am, you can have kids. Your femur is your thigh bone."

"Oh, I though it was a part of the vagina."

No, the thigh bone is not connected to the vagina-bone.

Thursday 26 January 2012

Happy endings

If you're expecting a stupid patient story today, you're out of luck.  I haven't told very many nice stories with happy endings, but after the miserable night on call I had last night, I think I need to cheer myself up.  If you don't like that...well, tough.

Domestic disputes piss me off.  They are usually one-sided, and the weaker person loses.  Unfortunately that's usually the woman.  Such is the case with this next patient, a very nice 30ish year old woman whose husband got mad at her.  Now I get into arguments with my wife, but they usually end up with me apologising, and then one of us makes a joke, and that's the end of it.  This guy, on the other hand, thought he'd settle the argument with a hammer upside his wife's head.  I'm not exaggerating.  He hit her in the head with a hammer.  You don't believe me?  Well look for yourself, non-believer:

She was taken immediately to the operating theatre to elevate that depressed portion of her skull and then to reconstruct it.  We kept her sedated for several days to allow the swelling and pressure inside her head to improve.

Amazingly, she started waking up about 2 weeks later.  That's great, right?  Unfortunately for her, that area  of the brain just under the injury on the left side of her head (right side of the picture...just use your imagination) is responsible for the production of speech (it's called "Broca's area").   She could understand exactly what we were saying and she wanted to talk back to us, but her injured brain didn't allow her to.  However, by the time I discharged her from the hospital about a month after the attack, she was able to get a few words out.

"THAT SUCKS, DOC!  SHE CAN BARELY TALK??" I hear you screaming.  Oh pipe down, you.  She walked into my office about a month later and was perfectly normal.  Her voice was normal and she could articulate perfectly.  She was  EXACTLY as she was before the attack...except for the titanium plates in her head and no ring on her finger.

Wednesday 18 January 2012

RFO time again!

That's right folks, it's rectal foreign object time again! That seems to be everyone's favourite topic and gets the most hits, so you can consider this some shameless self-promotion.

I need to start asking these people exactly what they were thinking as they inserted these things into their rectums. I imagine it's something like, "Oh that feels good!  But I hope I can get this thing back out again!" In my mind, they should be thinking, "What could possibly go wrong? What's my backup plan in case something goes awry?" Unfortunately you just can't anticipate some things.

Take for instance this guy who never in a million years thought anything could backfire in his plan. 

That dark tube-like structure right in the middle of the picture is the vibrator he inserted. Look carefully at the bottom of it. Go ahead, zoom in. I'll wait.

Notice how the bottom is jagged, not smooth? That's because the bottom of the vibrator broke off as he was trying to pull it out. How?  Why the hell are you asking me?  I've never stuck anything...nevermind.  Fortunately the batteries came out too, but with that sharp broken plastic, he wisely chose not to reach in and try to extract it himself.

I got it back out with little difficulty. After the procedure he vanished like a fart in the wind.

Tuesday 17 January 2012


Someone asked me today what my craziest experience was in the operating room.  This particular event still seems to be out of a movie, because it's almost too strange to believe.

I was doing my transplant surgery rotation during my 4th year of surgical training, and I was assisting one of the transplant surgeons on a laparoscopic donor nephrectomy (taking a kidney out of one person through very small incisions so that it can be transplanted into another person). After clamping and cutting the major blood vessels and the ureter, the kidney is placed into a plastic bag that's attached to a handle, and we then extract the bag through one of the incisions, which we keep as small as possible. Sometimes the incisions are just too small and the bag won't fit through without a lot of pulling and tugging.  Fortunately the bags are quite strong and designed to take this kind of abuse.  Well...maybe not THIS much abuse.

The kidney went in the bag and the surgeon was trying to pull it out.  She pulled...and pulled...and pulled...until finally the kidney popped out, the bag broke, and the kidney landed with a very dull *plop* on the floor.

For what seemed like minutes (but was probably only a second or two)...DEAD SILENCE.

She picked up the kidney, put it into the basin of ice, burst into the adjoining operating theatre where the transplant recipient was waiting for the kidney, and yelled, "I DROPPED THE FUCKING KIDNEY!"

There were a few lacerations on it that we had to repair, and we still implanted it, and fortunately it still worked. But it was definitely a surreal experience.

Monday 16 January 2012


If you've seen the movie "Inception" then you know it's about dreams within dreams within dreams.  (If you haven't seen it, what the hell are you waiting for?  Go see it!)  This next story I like to call "Dumbception" because it's just multiple layers of dumb.

Two nights ago I got a call that the medics were bringing in a fall at 3 AM.  I watched through bleary eyes as they wheeled in a young kid who looked no older than 15 and was completely unconscious and covered with 3 thick blankets that were clearly NOT from the medics.  My eyebrows raised just a little bit.  He had a little bruise next to his right eye and a band-aid over his left temple (medics NEVER use band-aids).  My eyebrows raised just a little bit more.  The medics then launched into their story - they got a call to check on this child who was asleep on a porch, and when they got there and saw the band-aid, they thought he had been beaten up.  Thus he was called a trauma.

To me, the kid looked passed out drunk.  I looked at the medics, and they both slowly shrugged as they gathered their stuff and walked out.  After shaking my head several times I got a quick CT scan of his brain and face, and I saw that everything was normal.

The story came out a few hours later - the kid was 14 years old, drinking and smoking marijuana with his buddies, and he passed out.  Some kind citizen saw him asleep on the porch in sub-freezing temperatures, and instead of CALLING HIS MOTHER they put some blankets on him.  His blood alcohol level (remember, he's 14 YEARS OLD) was 0.27, over three times the legal limit (were it legal for him to drink, which it is not).

If my kids ever pull any shit like this, they're getting locked in their rooms until they go to college.

Thursday 12 January 2012


For those who speak The Queen's English, this post refers to the Egyptian-style mummy, not the woman who birthed you.  I just thought I'd get that out of the way to avoid confusion and to prevent you from thinking this post is about my mother.  She's just fine, by the way.

This particular patient is from my training, though there are some patients and some conditions I've seen that are so bizarre it feels like it was yesterday.  I'll warn you - if you don't like gory stories, turn back now.

I was asked to see a patient with "active arterial bleeding" in the trauma bay.  This usually indicates a stabbing or a shooting, but in this case...not so much.  Well, actually it was a stabbing.  Sort of.  I walked up to the patient who smelled vaguely of a landfill, and I immediately noticed his right wrist bandaged tightly.  I asked the nurse what the problem was, and with a crooked smile he said simply, "Take the dressing down.  You'll see".

When I took off the gauze, what greeted me was a mummified hand that looked sort of like this:
...except that it was attached to a very much alive-appearing arm.  And yes, it was actively spurting blood.  I quickly applied a pressure dressing and asked the patient what the hell was going on.  My father always taught me "Don't ask a question that you don't want to know the answer to."  Well, I was not quite prepared for this particular answer.

It turns out the guy was a heroin addict, and he had run out of veins to inject several months prior.  So in his desperation, he began shooting into his radial artery (the "pulse" in your wrist).  That site quickly got infected, so he tried to dig the infection out (his words) ice pick.  A dirty ice pick.  Where the hell do you even get an ice pick these days?  Well, that obviously didn't work so well, and after a while, the hand lost its blood supply and died.  And all the while he continued shooting into the artery.  And now that artery was shooting blood up to the ceiling.

He lost his arm, and his injection site, later that day.

Tuesday 10 January 2012

The end is nigh...

Suicide isn't funny. Depression isn't funny. Sometimes, however, the world just throws you a curveball, and you can't help but chuckle at an otherwise sad situation. Seems like an oxymoron, eh?

I was called to do a trauma consultation on the psych ward (UH OH!) for a young lady who tried to commit suicide by cutting her wrist. As I've said, the hardest part about a suicide attempt is trying to guarantee that the attempt will not be successful.

I rushed to the psych ward expecting a scene out of "The Shining" - blood gushing down the hall. But when I got there and was buzzed in through the nuclear bomb shelter-type door, I introduced myself as the trauma surgeon on call, and the nurse trudged off slowly to find the patient, telling me to wait right here.


He came back several agonizing minutes later with the young lady who may have been attractive if it had not been for the slack-jawed medicine-induced look of sheer apathy on her face. Her wrist was loosely wrapped in gauze. I looked at the nurse as if to ask if this was the correct patient. He just stared at me expectantly.

I unwrapped her wrist and saw 3 tiny scratches. "This?" I asked incredulously, pointing. "Yes," the nurse replied. "That's what she did with the plastic knife. Does she need stitches?"

Plastic knife? Stitches? She got a few butterfly strips, and I left.

They called me back 2 days later for the same patient. Plastic knife, same wrist. Again.

I politely asked them to take her plastic knife away now, please. They really put the "moron" in "oxymoron".

Sunday 8 January 2012

Child abuse?

I'm going to do something I've never done before - I'm going to ask the advice of you, the reader.  I saw a patient today that made my blood boil, and I'm not sure if what she did constitutes child abuse.  Whether it is or not, it's stupid to say the least.

The patient is a 27 year old woman who is 7 months pregnant who crashed her car into a tree.  She had no specific complaints, but the paramedics brought her in mainly because she is very pregnant.  I have no problem with that whatsoever.  Even if there is minimal damage to the car, any large physiologic stress can induce labor, so these women SHOULD be brought in for evaluation.  My initial survey didn't show any obvious injuries, but she seemed to be acting strangely, and her eyes seemed to be darting back and forth very quickly.  And her breath smelled a bit funny.

Fortunately her entire workup was negative...except for her urine drug screen.  As I suspected, it was positive for PCP.

Now before you decide if this was child abuse or not, I forgot to add one final detail - her 1-year old son was in the car with her, too.  He was fine, fortunately.

She got up and walked out of the ER and disappeared.  Before I got a chance to call the police.

Wednesday 4 January 2012

How stupid can you be?

Things that should be illegal but aren't:
  • Flamethrowers
  • Thermite
  • Infant high heels
  • Short shorts for little girls that have "PINK" written across the ass
  • Salvia
  • Cigarettes
  • Stupidity

Sometimes people transcend stupid to some kind of meta-stupid, and they do things so stupid it's nearly incomprehensible. 

I don't see a lot of burns because burn patients typically go to a hospital that has a special burn unit rather than to a trauma center.  But I did see one gentleman who had sustained burns to his arms and face, and the paramedics who brought him in were chuckling to themselves.  Turns out the guy was washing the side of his van, but he was having some trouble scrubbing some off some grease.  So he chose a solvent that works very well for cleaning grease and tar - gasolineWHILE HE WAS SMOKING.  Now what could possibly go wrong?

Shockingly, the fumes ignited, setting both the van and him on fire.  His burns were relatively minor, and he was treated at an appropriate facility.  But I can only hope he learned something.

Now if only there were a way to outlaw stupidity...

Not dead

I'll start this post by answering a few questions that may or may not be burning in your mind: No, I'm not dead.  No, I didn't g...