Monday, 14 September 2015

Self-writing

It's been nearly 4 years since I started this blog, and with every new post I find it harder and harder to find material that isn't boring, repetitive, or both.  I'd like to write about homeopathy, seatbelts, antivaccinationists, or smoking every week, but I suspect I would lose and/or bore everyone to tears by doing so.  Instead, I wait for the truly good stories, ones that I find inspiring or unusual. Barring that, I sometimes take more mundane subjects and try to spin them in an interesting way.

And sometimes the stories just write themselves.

I ordinarily hate phone calls from emergency physicians at midnight.  Rarely do I answer the phone and hang up with a smile.  By now you've probably guessed that's exactly what happened recently.  You'll find out why I was smiling momentarily, I promise. And I guarantee you'll end up smiling too.  And maybe even laughing your ass off.  Or maybe scowling.  Possibly vomiting.  Whatever.

No promises. 

Dr. Elise (not her real name™), a lovely and strangely competent emergency physician, had a rather strange lilt to her voice when I picked up the phone.  I immediately suspected by the tone of her voice what was coming, and boy was I ever right.  I like being right.

Dr. Elise: Hi, Doc.  So I have this really nice guy with his really nice wife. They were, uh, having some, uh, fun.  And then it got, eh, lost. 
Me: It?
Dr. Elise: Yeah, it
Me (smiling): What exactly is it?
Dr. Elise: ...
Me (smiling bigger): Elise?
Dr. Elise: ...
Me (chuckling audibly): Eliiiiiiise?
Dr. Elise: A . . . a vibrator. 

Smiling yet?  Because you know damned well a picture is coming.  I hadn't had a rectal foreign object in quite some time.  If you're wondering why I was so excited, you're not alone, because Dr. Elise and two of her colleagues asked me the exact same question.  Why do I get so damned giddy at rectal foreign objects?  Do I have some strange fetish?  Do I enjoy the schadenfreude?  Am I just a sick, perverted bastard?  No, I told her, the answer is much  more mundane than that: removing RFOs is very, very satisfying.  

For me, that is. 

Anyway, I got to the hospital a few minutes later, and I did my best to suppress my giddiness as I walked in.  I have no idea what most people would think of a surgeon with a stupid grin on his face as he walks into the hospital, but I suspect it would be nothing good.  Probably some serial chainsaw killer shit.  I went straight to the radiology computer and pulled up his X-ray:
Yep, that's a vibrator all right, I thought.  A BIG one.  Now to get it out.  

On the X-ray it looked awfully high in his rectum (yes his), so I went to get a pair of ring forceps that I suspected I would need.  I then went in to his room to introduce myself.  He looked terribly uncomfortable sitting there next to his wife.  Obviously.

Me: Hello, I'm Doctor {Redacted}.  You're Mr. Patterson (not your real name™)?
Mr. Patterson: Ugh.  Yes.
Me: Nice to meet you.  And you're Mrs. Patterson?

They both glanced at each other, looked at the floor, and whispered, in unison, "No."

See?  This stuff just writes itself sometimes.

As expected, I could barely feel the base of the vibrator with the tip of my finger.  And also as expected, it was caught under the sacrum.  Fortunately I was just able to nudge the base of it over the sacrum with my fingertip.  I slid the forceps along the length of my finger, grabbed it, and told him "Push."

He pushed.  I pulled.  

*PLOP*

It was a very satisfying *plop*, which reinforced why I like these cases so much.  I then held up their lost toy and asked them both if they wanted it back.  They both wordlessly shook their heads vigorously, so I threw it straight in the bin, accepted their heartfelt thanks, said goodbye, and walked out. 

No embellishment needed this time.  None at all.
 

50 comments:

  1. I think you mean "meet" and not "meat", doc.

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    Replies
    1. Quite right. Dictation software is great until it trolls you.

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    2. In this case, I think "meat" was much funnier-you should have left it, Doc!

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    3. I hereby volunteer myself as a medical transcriptionist. Laughing out loud whilst typing letters is a perk of my job. As is googling things I hear but don't quite understand and exclaiming when I find photos.

      Side note - that vibrator looks to me like a front view of an open flick knife. The thin line extending diagonally up and left from the top of it made me think of a blade. So glad it isn't.

      And since I'm not reading your blog to learn all the ins and outs of anaesthesia and analgesia, I myself am totally cool with not hearing all of those details. My boyfriend was cackling when I got to the *plop* part of the story, reading it aloud to him last night.

      Keep being awesome!!

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    4. Makes my day. A medical problem that I don't have! BTW, what IS the line extending diagonally from this...thing? Makes it looks like a big fat syringe...with needle...ugh!

      Keep up the great work - I'm sure there's always something!

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  2. Out of this whole tale, the part I found most horrifying was when you referred to Dr. Elise (not her real name™) as a "strangely competent emergency physician." I truly hope you just meant uniquely competent, as in holy shit! she's incredible. My fear is that you meant holy shit! she didn't leave a glove and a scalpel in the incision as she closed up the cut she made on the wrong leg, like most of the emergency physicians I see. ::whimper::

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    Replies
    1. Unfortunately, my intention was closer to the latter than the former.

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    2. having read some of your other comments on emergency physicians I suspected as much.

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  3. I wondered about that comment as well, trying to imagine what being strangely competent means.

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    1. Especially when she was described as being, "a lovely but strangely competent emergency physician" as if the two were mutually exclusive.

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    2. Not mutually exclusive, though very rare.

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  4. No IV? Did patient receive Ativan/Narcotic/lido perianal bloc before you performed manual extraction? Those are standard procedure in the US. Sigmoidoscopy or colonoscopy should have been performed also after removal of the object to detect mucosal injury.You did not mention them.

    No offense doc but you remind me of this guy below:

    OVERLAND PARK — U.S. Senate candidate Milton Wolf posted a collection of gruesome X-ray images of gunshot fatalities and medical injuries to his Facebook page and participated in online commentary layered with macabre jokes and descriptions of carnage. Milton Wolf, who is challenging Sen. Pat Roberts in the GOP primary is a Johnson County radiologist who is generating controversy with especially graphic X-ray images of his patients posted on his Facebook page.

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    1. Congratulations, Doc, it seems you have a hater.

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    2. Yes, please Doc, list every single drug or drip that is used on every single patient you write about, the dosage, and who administered it. Please also include all conversations, verbatim, that happen when the patient is under your care. Describe in detail the room and general atmosphere of the team working with you - could you smell tuna on anybody's breath? Were some of the staff wearing Crocs?

      Anon (11:34), I would recommend getting your own blog if you don't like this one. The rest of us are very happy with what we read here or we wouldn't keep coming back for more.

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    3. Gristle: That's why I asked. Rectal foreign body removal via manual extraction is a painful procedure. I never had it done but it's common sense. Hence, those are very important details. Doc never answered my question.

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    4. Anon: Gristle's point is that we don't care. They are only important details if it's a procedure that you are going to be involved in. Personally, I'm pretty sure I won't be so the details are much less important to me than the general flow of the narrative. I suspect the same applies fairly broadly.

      From your detailed interest it sounds like you anticipate needing to know the ins-and-outs (pun intended) of the procedure, and that's your business, but I'm sure you can Google them without troubling the Doc'.

      Ugi

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    5. it sounds more to me like the person wants to defame Doc.
      Hmm... who have we known recently who fits that profile?

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    6. as I recall, he also never went into detail about what drugs were used in last week's story, and I'm sure that was at least a mildly uncomfortable procedure.

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    7. Anon - No, I sure didn't answer your question, since it is completely irrelevant. Hopefully you're bright enough to realise what that means for any future similar questions.

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    8. Ugi: That makes you incurious and uninterested. Kinda like the close-minded people who are unreceptive to new ideas, and kinda like the machines we have on this page.

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    9. Doc: When you write a story, you have to be clear and precise. Otherwise, people are going to ask and question.

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    10. John, the only person asking useless questions is you. As you may or may not have noticed from other posts, I am always happy to answer questions that are relevant. Yours are not. Draw your own conclusion.

      And as another commentor suggested earlier, if you're dissatisfied, there are literally millions of other blogs out there. I'm sure you'll be able to find a blogger who is more receptive and tolerant than I.

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    11. Anon: " Rectal foreign body removal via manual extraction is a painful procedure. I never had it done ..."
      That's as clear an admission of his problem as we need... if he'd have it done he could probably see better...

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    12. This comment has been removed by a blog administrator.

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    13. I think anonymous @15 September 2015 at 11:34 is John Benton trying to be clever.

      W

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    14. Now I'm tempted to write dorky anonymous comments to see if everyone decides I'm John Benton.

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    15. Susan - please don't. One actual troll is quite enough. The last thing we need here is a copycat.

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    16. Ken, your comment - I'm laughing so hard I am crying at work! I never checked the comments until Dr. B made a post about The Troll. I decided I was missing out and now I try to come back to each post a week later and check the comments - I have yet to be disappointed! This guy is a nut! He reminds me of the guy I sit next to at work - always needs to know more than everyone else about every subject, even when he knows nothing... hey, I may have found the real John! ;)

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    17. hmm... how to do empirical testing...

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    18. Hi Doc B. I love your "That's nice" comment, I too am a fan.
      Keep up the good work as i love reqading your latest post at bedtime and going to bed with a smile or outright chortle.

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  5. What brand of batteries were in the vibrator? What color was it? Did it have multi-speeds or just one setting?
    Did the patient have any drug allergies? Any tattoos? Any religious preference?
    Had you eaten a good dinner that evening? How, exactly, did you get to the hospital? Did you obey all traffic laws on the way?

    These details MATTER, damnit!

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    Replies
    1. What colour were the patient's eyes? Shirt? Pants? How about the walls in the room? Which floor was the room on? THESE ARE RELEVANT TO THIS STORY!1111q!1

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    2. Blue! No, yellow! Aaaaaaaaaaahhhhh!

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    3. It's called attention to detail. You may save a life one day.

      _/..../._/_./_._/ _._ _/_ _ _/.._/

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  6. Hi Doc! I Love the blog and I have been reading for a while now. I've never commented before but after seeing the word 'schadenfreude' i have to ask: have you ever heard the song schadenfreude from the musical Avenue Q? Seems like it be a song you'd like!

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    1. I'm not much a "musicals" type of guy. But I'll check it out.

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    2. understandable. the musical itself is like adult sesame street. ha! but the song I'm talking about is being happy at the misfortune of others. lol.

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  7. My daughter had me listen to Avenue Q when she was in high school. I laughed until I cried. Then I hid the iPod from her younger brother.

    Background: my daughter sang "Poisoning Pigeons in the Park" for a middle school talent show. Wearing a feather boa.

    Wednesday

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    1. Omg. That's awesome. Your daughter is a girl after my own heart.

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    2. I'm very proud of her. She's earning her master's now and will be teaching history as a full-time teacher next year, we hope. I hope they pay her enough to have her own bed rather than taking turns sleeping on a cot.

      Wednesday

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  8. You have new readers (or at least one!) who don't have time to read all of your archives and hope you will keep writing, even if it's repetitious!

    As a non-medical person who wanted to be a medical person but was just too lazy and needed too much sleep- even I know that nothing should ever go into the anus unless it has a widely flanged end...and even then, the propensity of the anus to suck in is stunning, to say the least.

    Not that I know from personal experience. ;-)

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  9. A similar situation happened where I worked once EXCEPT the vibrator never turned off on its own, the patient needed surgery, and he kept on screaming at his wife loud enough for everyone to hear how "it is your fault that I had to resort to this to satisfy my needs". Unfortunately, this happened way before the time I started working in the ER.

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    Replies
    1. Damned women without penises! Bahahahaha!

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    2. Anonymous 05:16, gee, didn't he know about Mrs. Palmer and some lotion? He probably had ED. Most men would rather blame their partner than admit their equipment isn't functioning.

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    3. He does know that they do make toys for men, right? Particularly ones with bases so they don't get "eaten".

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    4. Shark - I've seen one of those get lost too.

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  10. Too bad someone cant send Benton the vibrator. perhaps he would FINALLY have something better to do than be a troll on this blog!!!

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  11. I started reading this blog when looking for stuff about the Jahi McMath situation nearly two years ago so I haven't read the prior two years worth of stories. I do know that since I've been reading I don't recall Doc posting any stories having to do with VFB. After seeing the following article on Medpage, I wondered if Doc had any similar experiences or has he just dealt with RFB:

    http://www.theguardian.com/healthcare-network/2015/aug/20/removed-toy-dinosaur-womans-vagina

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    Replies
    1. Wow...Doc is absolutely right...some stories just write *themselves*...

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